----------------------------------------
--------------------------              
,transcriber's ,note                    
,in ,lecture ,i1 there are paragraphs   
numbered #a to #h but omitting      #d4 
,this is as in the original1 as is the  
inconsistent                hyphenation 
of the words lawgiver and twofold4 ,in  
two            instances1 errors of     
punctuation have been corrected1 and in 
one     case obscured words have been   
guessed4 ,full details can be found     
in the html version of this ebook4      
----------------------------------------
--------------------------              
,,moral ,,principles ,,and              
,,medical ,,practice1                   
,,the ,,basis ,,of ,,medical            
,,jurisprudence4                        
,,by                        ,,rev4      
,,charles ,,coppens1 ,s4,j41            
,professor of ,medical ,jurisprudence in
 the ,john ,a4 ,creighton   ,medical    
,college1 ,omaha1 ,neb41 author of      
,text-,books on ,metaphysics1           

,ethics1 ,oratory1 and ,rhetoric4       
,,new ,,york1 ,,cincinnati1 ,,chicago3  
,,benziger ,,brothers1                  
,printers to the ,holy ,apostolic ,see4 
,,to                          ,,mr4     
,,john ,a4 ,,creighton1                 
,,the ,,founder ,,of ,,this ,,medical   
,,college                               
,,and ,,of                         ,,st4
 ,,joseph',s ,,hospital1                
,,as                        ,a ,,slight 
,,tribute ,,of ,,honor                  
,,for                  ,,his            
,,enlightened ,,patronage ,,of          
,,learning                              
,,and              ,,his ,,christian    
,,charity ,,towards ,,his               
,,fellow-,,men1                         
,,this ,,volume                         
,,is                                    
,,respectfully ,,inscribed4             
,permissu ,superiorum4   ,the           
undersigned1 ,provincial of the         
,missouri ,province of the ,society of  
,jesus1 in virtue of faculties granted  

to him by ,very ,rev4 ,l4 ,,martin1     
,general of the same ,society1 hereby   
permits the publication of a book       
entitled ,moral ,principles and ,medical
 ,practice1 by ,rev4 ,,charles          
,,coppens1 ,s4,j41 the same having been 
approved by the censors appointed by him
 to revise it4                  ,,thomas
 ,s4 ,,fitzgerald1 ,s4,j4      ,,st4    
,,louis1 ,,mo41 ,july #b1 #ahig4        
99       99       99       99       99  
,imprimatur4                   ,,michael
 ,,augustine1                           
,archbishop of ,new ,york4      ,,new   
,,york1 ,july #bj1 #ahig4               
,,copyright1 #ahig1 ,,by ,,benziger     
,,brothers4     ,,preface4   ,the       
science of ,medicine is progressive2    
genius irradiates its onward march4 ,few
 other sciences have advanced as rapidly
 as it has done within the last half    
century4 ,hence it has happened that in 
many of its branches text-books have not
 kept pace with the knowledge of its    
leading minds4 ,such is confessedly the 

case in the department of ,medical      
,jurisprudence4 ,this very term1        
,medical ,jurisprudence1 as now used in 
colleges1 is generally acknowledged to  
be a misnomer4 ,there is no reason why  
it should be so used4 ,the leading      
medical writers and practitioners are   
sound at present on the moral principles
 that ought to direct the conduct of    
physicians4 ,it is high time that their 
principles be more generally and        
distinctly inculcated on the younger    
members1 and especially on the students 
of their noble profession4 ,to promote  
this object is the purpose aimed at by  
the author4 ,his brief volume is not    
intended to be substituted for existing 
text-books on ,medical ,jurisprudence1  
but to supply some chapters imperatively
 demanded by science for the thorough   
treatment of this important subject4    
,,contents4                             
,,page   ,,lecture                      
,i4--,,introduction--,,the ,,foundation 
,,of ,,jurisprudence1      #aa          

,,ii4--,,craniotomy1                    
#cg         ,,iii4--,,abortion1         
#eh          ,,iv4--,,views ,,of        
,,scientists ,,and ,,sciolists1         
#ha           ,v4--,,venereal           
,,excesses1                             
#ajd          ,,vi4--,,the              
,,physician',s ,,professional ,,rights  
,,and ,,duties1    #abh                 
,,vii4--,,the ,,nature ,,of ,,insanity1 
#aea        ,,viii4--,,the ,,legal      
,,aspects ,,of ,,insanity1              
#agg          ,,ix4--,,hypnotism ,,and  
,,the ,,border-,,land ,,of ,,science1   
#aig     ,,moral ,,principles ,,and     
,,medical ,,practice4     ,,lecture ,i4 
,,introductory--,,the ,,foundation ,,of 
,,jurisprudence4   ,gentlemen3--#a4     
,when ,i thoughtfully consider the      
subject on which ,i am to address you in
 this course of lectures1 i4e41 ,medical
 ,jurisprudence1 ,i am deeply impressed 
with the dignity and the importance of  
the matter4  ,the study of medicine is  
one of the noblest pursuits to which    

human talent can be devoted4 ,it is as  
far superior to geology1 botany1        
entomology1 zology1 and a score of      
kindred sciences as its subject1 the    
body of man1 the visible lord of the    
creation1 is superior to the subject of 
all other physical sciences1 which do so
 much honor to the power of the human   
mind2 astronomy1 which explores the vast
 realms of space1 traces the courses and
 weighs the bulks of its mighty orbs2   
chemistry1 which analyzes the minutest  
atoms of matter2 physics1 which         
discovers the properties1 and mechanics1
 which utilizes the powers of an endless
 variety of bodies--all these noble     
sciences together are of less service to
 man than that study which directly     
promotes the welfare of his own         
structure1 guards his very life1 fosters
 the vigor of his youth1 promotes the   
physical and mental1 aye1 even the      
moral1 powers of his manhood1 sustains  
his failing strength1 restores his      
shattered health1 preserves the         

integrity of his aging faculties1 and   
throughout his whole career supplies    
those conditions without which both     
enjoyment and utility of life would be  
impossible4  ,the physician1 indeed1 is 
one of the most highly valued           
benefactors of mankind4 ,therefore he   
has ever been held in honor among his   
fellow-men2 by barbarous tribes he is   
looked upon as a connecting link between
 the visible and the invisible world2 in
 the most civilized communities1 from   
the time of ,hippocrates1 the father of 
medicine1 to the present day1 he has    
been held in deeper veneration than the 
members of almost any other profession2 
even in the sacred oracles of           
,revelation his office is spoken of with
 the highest commendation3 ,honor the   
physician1 writes the inspired penman1  
for the need thou hast of him2 for the  
,most ,high hath created him4 ,the skill
 of the physician shall lift up his     
head1 and in the sight of great men he  
shall be praised4 ,the ,most ,high has  

created medicines out of the earth1 and 
a wise man shall not abhor them4 ,the   
virtue of these things is come to the   
knowledge of men1 and the ,most ,high   
has given knowledge to men1 that ,he may
 be honored in ,his wonders4 ,by these  
,he shall cure and shall allay their    
pains1 and of these the apothecary shall
 make sweet confections1 and shall make 
up ointments of health1 and of ,his     
works there shall be no end4 7,ecclus4  
xxxiii4 #a-g74  #b4 ,it is well to      
remind you thus1 gentlemen1 at the      
opening of this new year of studies1 of 
the excellence of your intended         
profession2 for you cannot help seeing  
that a science so noble should be       
studied for a noble purpose4 ,in this   
age of utilitarianism1 it is1 alas6 too 
common an evil that the most excellent  
objects are coveted exclusively for     
lower purposes4 ,true1 no one can find  
fault with a physician for making his   
profession1 no matter how exalted1 a    
means of earning an honest livelihood   

and a decent competency2 but to ambition
 this career solely for its pecuniary   
remuneration would be to degrade one of 
the most sublime vocations to which man 
may aspire4 ,there is unfortunately too 
much of this spirit abroad in our day4  
,there are too many who talk and act as 
if the one highest and worthiest        
ambition of life were to make as large a
 fortune in as short a time and in as   
easy a way as possible4 ,if this spirit 
of utilitarianism should become         
universal1 the sad consequence of it to 
our civilization would be incalculable4 
,fancy what would become of the virtue  
of patriotism if officers and men had no
 higher ambition than to make money6 ,as
 a patriotic army is the strongest      
defence of a nation's rights1 so a      
mercenary army is a dreadful danger to a
 people's liberty1 a ready tool in the  
hand of a tyrant2 as heroism with       
consequent glory is the noble attribute 
of a patriot1 so a mercenary spirit is a
 stigma on the career of any public     

officer4 ,we find no fault with an      
artisan1 a merchant1 or a common laborer
 if he estimate the value of his toil by
 the pecuniary advantages attached to   
it2 for that is the nature of such      
ordinary occupations1 since for man     
labor is the ordinary and providential  
condition of existence4 ,but in the     
higher professions we always look for   
loftier aspirations4 ,this distinction  
of rewards for different avocations is  
so evident that it has passed into the  
very terms of our language3 we speak of 
wages as due to common laborers1 of a   
salary as paid to those who render more 
regular and more intellectual services2 
of a fee as appointed for official and  
professional actions2 and the money paid
 to a physician or a lawyer is          
distinguished from ordinary fees by the 
especial name of honorary or honorarium4
 ,this term evidently implies1 not only 
that special honor is due to the        
recipients of such fees1 but besides    
that the services they render are too   

noble to be measured in money values1   
and therefore the money offered is      
rather in the form of a tribute to a    
benefactor than of pecuniary            
compensation for a definite amount of   
service rendered4  ,wages may be        
measured by the time bestowed1 or by the
 effect produced1 or by the wants of the
 laborer to lead a life of reasonable   
comfort2 a salary is measured by the    
period of service2 but an honorary is   
not dependent on time employed1 or on   
needs of support1 or on effect produced1
 but it is a tribute of gratitude due to
 a special benefactor4 ,whatever        
practical arrangements may be necessary 
or excusable in special circumstances1  
this is the ideal which makes the       
medical profession so honorable in      
society4  #c4 ,from these and many other
 considerations that might be added1 it 
is evident1 gentlemen1 that in the      
pursuit of the distinguished career for 
which you are preparing1 you are        
expected to make yourselves the         

benefactors of your fellow-men4 ,now1 in
 order to do so1 it will not suffice for
 you to understand the nature of the    
various diseases which flesh is heir to1
 together with the specific powers of   
every drug described in works on materia
 medica4 ,the knowledge of anatomy and  
surgery1 and of the various branches    
that are taught by the many professors  
with whom ,i have the honor of being    
associated in the work of your medical  
education1 no matter how fully that     
knowledge be mastered1 is not sure by   
itself to make you benefactors to your  
fellow-men1 unless your conduct in the  
management of all your resources of     
science and art be directed to procure  
the real welfare of your patients4 ,just
 as a skilful politician may do more    
harm than good to his country if he     
direct his efforts to improper ends1 or 
make use of disgraceful means2 as a     
dishonest lawyer may be more potent for 
the perversion than the maintenance of  
justice among his fellow-citizens2 so   

likewise an able physician may abuse the
 beneficent resources of his profession 
to procure inferior advantages at the   
sacrifice of moral rights and superior  
blessings4  ,your career1 gentlemen1 to 
be truly useful to others and pursued   
with safety and benefit to yourselves1  
needs to be directed by a science whose 
principles it will be my task to explain
 in this course of lectures--the science
 of ,,medical ,,jurisprudence4  ,it is  
the characteristic of science to trace  
results to their causes4 ,the science of
 ,jurisprudence investigates the causes 
or principles of law4 ,it is defined as 
the study of law in connection with its 
underlying principles4 ,medical         
,jurisprudence1 in its wider sense1     
comprises two departments1 namely1 the  
study of the laws regarding medical     
practice1 and1 more1 especially1 the    
study of the principles on which those  
laws are founded1 and from which they   
derive their binding power on the human 
conscience4 ,the former department1     

styled ,medical ,law1 is assigned in the
 ,prospectus of this ,college to a      
gentleman of the legal profession4 ,he  
will acquaint you with the laws of the  
land1 and of this ,state in particular1 
which regulate the practice of medicine2
 he will explain the points on which a  
,doctor may come in contact with the law
 courts1 either as a practitioner having
 to account for his own actions1 under a
 charge of malpractice perhaps1 or as an
 expert summoned as a witness before a  
court in matters of civil contests or   
criminal prosecutions4 ,his field is    
wide and important1 but the field of    
,medical ,jurisprudence1 in its stricter
 or more specific sense1 is wider still 
and its research much deeper3 it        
considers those principles of reason    
that underlie the laws of the land1 the 
natural rights and duties which these   
laws are indeed to enforce to some      
extent1 but which are antecedent and    
superior to all human laws1 being       
themselves founded on the essential and 

eternal fitness of things4 ,for things  
are not right or wrong simply because   
men have chosen to make them so4 ,you   
all understand1 gentlemen1 that1 even if
 we were living in a newly discovered   
land1 where no code of human laws had   
yet been adopted1 nor courts of justice 
established1 nor civil government       
organized1 still even there certain acts
 of ,doctors1 as of any other men1 would
 be right and praiseworthy1 and others  
wrong and worthy of condemnation2 even  
there ,doctors and patients and their   
relatives would have certain rights and 
duties4  ,in such a land1 the lecturer  
on ,medical ,law would have nothing to  
explain2 for there would be no human    
laws and law courts with which a        
physician could come in contact4 ,but   
the lecturer on ,medical ,jurisprudence 
proper would have as much to explain as 
,i have in this country at present2     
because he treats of the ,ethics or     
moral principles of ,medical ,practice1 
he deals with what is ever the same for 

all men where-ever they dwell1 it being 
consequent on the very nature of man and
 his essential relations to his ,maker  
and his fellow-man4 ,unfortunately the  
term ,medical ,jurisprudence has been   
generally misused4 ,dr4 ,ewell1 in his  
text-book on the subject1 writes ,while 
the term ',medical ,jurisprudence' is a 
misnomer1--the collection of facts and  
conclusions usually passing by that name
 being principally only matters of      
evidence1 and rarely rules of           
law1--still the term is so generally    
employed that it would be idle to       
attempt to bring into use a new term1   
and we shall accordingly continue the   
employment of that which has only the   
sanction of usage to recommend it 7,ch4 
,i74  ,i prefer to use terms in their   
genuine meaning2 for misnomers are out  
of place in science1 since they are     
misleading4 ,yet1 to avoid all danger of
 misunderstanding1 ,i will call my      
subject ,moral ,principles and ,medical 
,practice1 and distinctly style it ,the 

,basis of ,medical ,jurisprudence4  ,on 
what lines will my treatment of the     
subject depart from the beaten path8 ,on
 the same lines on which most other     
improvements have been made in the      
science of medicine4 ,science has not   
discovered new laws of physical nature  
that did not exist before2 but it has   
succeeded in understanding existing laws
 more perfectly than before1 and has    
shaped its practice accordingly4 ,so1   
too1 the leaders of thought among       
physicians1 especially in               
,english-speaking countries1 now        
understand the laws of moral nature--the
 principles of ,ethics--more thoroughly 
than most of their predecessors did1 and
 they have modified their treatment so  
as to conform it to these rules of      
morality4 ,hitherto ,medical            
,jurisprudence had regulated the conduct
 of practitioners by human1 positive    
laws1 and sanctioned acts because they  
were not condemned by civil courts4 ,now
 we go deeper in our studies1 and appeal

 from human legislation to the first    
principles of right and wrong1 as       
,jurisprudence ought to do2 and1 in     
consequence1 some medical operations    
which used to be tolerated1 or even     
approved1 by many in the profession are 
at present absolutely and justly        
condemned4 ,the learned physician these 
days is no longer afraid to face the    
moral philosopher2 there is no longer   
any estrangement between ,ethics and    
,medical ,practice4 ,medicine1 sent from
 ,heaven to be an angel of mercy to man1
 is now ever faithful to its beneficent 
mission2 it never more performs the task
 of a destroying spirit1 as--not in     
wantonness1 but in ignorance--it did    
frequently before4  ,on these lines1    
then1 of the improved understanding of  
first principles1 ,i will now proceed to
 develop the teachings of ,medical      
,jurisprudence4  ,the first principle   
that ,i will lay down for explanation   
is1 that a man is not to be held        
responsible for all his acts1 but only  

for those which he does of his own free 
will1 which1 therefore1 it is in his    
power to do or not to do4 ,these are    
called human acts1 because they proceed 
from a distinctively human power4 ,a    
brute animal cannot perform such acts2  
it can only do under given circumstances
 what its impulses prompt it to do2 or1 
when it experiences various impulses in 
different directions1 it can only follow
 its strongest impulse2 as when a dog1  
rushing up to attack a man1 turns and   
runs away before his uplifted stick4    
,when a bird sings1 it cannot help      
singing2 but a man may sing or not sing 
at his choice2 his singing is a human   
act4 ,when1 however1 under the impulse  
of violent pain1 a person happens       
involuntarily to sigh or groan or even  
shriek1 this indeed is the act of a man1
 but1 inasmuch as it is physically      
uncontrollable1 it is not a human act4  
,so whatever a patient may do while     
under the influence of chloroform is not
 a human act1 and he is not morally     

responsible for it4 ,his conduct under  
the circumstances may denote a brave or 
a cowardly disposition1 or it may       
indicate habits of self-command or the  
absence of them4 ,his prayers or curses 
while thus unconscious are no doubt the 
effects of acquired virtues or vices2   
yet1 in as far as his will has no share 
in the present acts1 they are not free  
or human acts4 ,he deserves praise or   
blame for his former acts1 by which he  
acquired such habits1 but not for his   
unconscious acts as such4  ,from this   
principle it follows that a physician is
 not responsible to ,god or man for such
 evil consequences of his prescriptions 
or surgical operations as are entirely  
beyond his will and therefore           
independent of his control4 ,if1        
however1 his mistakes arise from his    
ignorance or want of skill1 he is       
blamable in as far as he is the wilful  
cause of such ignorance2 he should have 
known better2 or1 not knowing better1 he
 should not have undertaken the case for

 which he knew he was not qualified4    
,but it often happens that the best     
informed and most skilful practitioner1 
even when acting with his utmost care1  
causes real harm to his patients2 he is 
the accidental1 not the wilful1 cause of
 that harm1 and therefore he is free    
from all responsibility in the matter4  
,the practical lessons1 however1 which  
all of you must lay to heart on this    
subject are3 #ast4 ,that you are in duty
 bound to acquire sound knowledge and   
great skill in your profession2 since   
the consequences involved are of the    
greatest moment1 your obligation is of a
 most serious nature4 #b;d4 ,that in    
your future practice you will be obliged
 on all occasions to use all reasonable 
care for the benefit of your patients4  
#c;d4 ,that you cannot in conscience    
undertake the management of cases of    
unusual difficulty unless you possess   
the special knowledge required1 or avail
 yourselves of the best counsel that can
 reasonably be obtained4  #e4 ,a second 

principle of ,ethics in medical         
practice1 gentlemen1 is this1 that many 
human acts may be highly criminal of    
which1 however1 human laws and courts   
take no notice whatsoever4 ,in this     
matter ,i am not finding fault with     
human legislation4 ,the laws of the     
land1 considering the end and the nature
 of civil government1 need take no      
cognizance of any but overt acts2 a     
man's heart may be a very cesspool of   
vice1 envy1 malice1 impurity1 pride1    
hatred1 etc41 yet human law does not and
 ought not to punish him for this1 as   
long as his actions do not disturb the  
public peace nor trench upon the        
happiness of his neighbor4 ,even his    
open outward acts which injure only     
himself1 such as gluttony1 blasphemy1   
impiety1 private drunkenness1           
self-abuse1 even seduction and          
fornication1 are not usually legislated 
against or punished in our courts4 ,does
 it follow that they are innocent acts  
and lawful before ,god8 ,no man in his  

right senses will say so4  ,the goodness
 and the evil of human acts is not      
dependent on human legislation alone2 in
 many cases the moral good or evil is so
 intrinsic to the very nature of the    
acts that ,god ,himself could not change
 the radical difference between them4   
,thus justice1 obedience to lawful      
authority1 gratitude to benefactors1 are
 essentially good2 while injustice1     
disobedience1 and ingratitude are       
essentially evil4 ,our reason informs us
 of this difference2 and our reason is  
nothing else than our very nature as    
intelligent beings capable of knowing   
truth4 ,the voice of our reason or      
conscience is the voice of ,god         
,himself1 who speaks through the        
rational nature that ,he has made4      
,through our reason ,god not only tells 
us of the difference between good and   
evil acts1 but ,he also commands us to  
do good and avoid evil2--to do certain  
acts because they are proper1 right1    
orderly1 suitable to the end for which  

we are created2 and to avoid other acts 
because they are improper1 wrong1       
disorderly1 unsuitable to the end of our
 existence4 ,there is a third class of  
acts1 which1 in themselves1 are         
indifferent1 i4e41 neither good nor     
evil1 neither necessary for our end nor 
interfering with its attainment4 ,these 
we are free to do or to omit as we      
prefer2 but even these become good and  
even obligatory when they are commanded 
by proper authority1 and they become    
evil when forbidden4 ,in themselves1    
they are indifferent acts4  #f4 ,these  
explanations are not mere abstractions1 
gentlemen1 or mere philosophical        
speculations4 ,true1 my subject is      
philosophical2 but it is the philosophy 
of every-day life2 we are dealing with  
live issues which give rise to the      
gravest discussions of your medical     
journals2 issues on which practically   
depend the lives of thousands of human  
beings every year1 issues which regard  
physicians more than any other class of 

men1 and for the proper consideration of
 which ,doctors are responsible to their
 conscience1 to human society1 and to   
their ,god4 ,to show you how we are     
dealing with present live issues1 let me
 give you an example of a case in point4
 ,in the ,medical ,record1 an estimable 
weekly1 now in almost the fiftieth year 
of its existence1 there was lately      
carried on a lengthy and1 in some of its
 parts1 a learned discussion1 regarding 
the truth of the principles which ,i    
have just now explained1 namely1 the    
intrinsic difference between right and  
wrong1 independently of the ruling of   
law courts and of any human legislation4
 ,the subject of the discussion was the 
lawfulness in any case at all of        
performing craniotomy1 or of directly   
destroying the life of the child by any 
process whatever1 at the time of        
parturition1 with the intention of      
saving the life of the mother4  ,i will 
not examine this important matter in all
 its bearings at present2 ,i mean to    

take it up later on in our course1 and  
to lay before you the teachings of      
science on this subject1 together with  
the principles on which they are based4 
,for the present ,i will confine myself 
to the point we are treating just now1  
namely1 the existence of a higher law   
than that of human tribunals1 the       
superiority of the claims of natural to 
those of legal justice4 ,some might     
think1 at first sight1 that this needs  
no proof4 ,in fact we are all convinced 
that human laws are often unjust1 or1 at
 least1 very imperfect1 and therefore   
they cannot be the ultimate test or     
fixed standard of right and wrong2 yet  
the main argument advanced by one of the
 advocates of craniotomy rests upon the 
denial of a higher law1 and the         
assertion of the authority of human     
tribunals as final in such matters4  ,in
 the ,medical ,record for ,july #bg1    
#ahie1 p4 #ada1 this gentleman writes in
 defence of craniotomy3 ,the question is
 a legal one per se against which any   

conflicting view is untenable4 ,the     
subdivisions under which the common law 
takes consideration of craniotomy are   
answers in themselves to the conclusions
 quoted above1 under the unfortunate    
necessity which demands the operation4  
,next he quotes the ,ohio statute law1  
which1 he remarks1 was enacted in       
protection of physicians who are        
confronted with this dire necessity4 ,he
 is answered with much ability and sound
 learning by ,dr4 ,thomas ,j4 ,kearney1 
of ,new ,york1 in the same ,medical     
,record for ,august #ca1 #ahie1 p4 #cbj1
 who writes3 ,dr4 ,g4 bases his argument
 for the lawfulness of craniotomy in the
 teachings of common law1 contending1 at
 least implicitly1 that it is           
unnecessary to seek farther the desired 
justification4 ,however1 the basis of   
common law1 though broad1 is certainly  
not broad enough for the consideration  
of such a question as the present one4  
,his coolness rises to sublime heights1 
in thus assuming infallibility for      

common law1 ignoring the very important 
fact that behind it there is another and
 higher law1 whose imperative1 to every 
one with a conscience1 is ultimate4 ,it 
evidently never occurs to him that some 
time could be profitably spent in       
research1 with the view to discovering  
how often common-law maxims1 seen to be 
at variance with the principles of      
morality1 have been abrogated by        
statutory enactments4 ,now the maxims of
 common law relating to craniotomy1 the 
statutes in conformity therewith1 as    
well as ,dr4 ,g4's arguments 7some of   
them at least71 rest on a basis of pure 
unmitigated expediency2 and this is     
certainly in direct contravention of the
 teachings of all schools of moral      
science1 even the utilitarian4  ,dr4    
,kearney's doctrine of the existence of 
a higher law1 superior to all human law1
 is the doctrine that has been          
universally accepted1 in all ,christian 
lands at least1 and is so to the present
 day4 ,froude explains it correctly when

 he writes3 ,our human laws are but the 
copies1 more or less imperfect1 of the  
eternal laws so far as we can read them1
 and either succeed and promote our     
welfare or fail and bring confusion and 
disaster1 according as the legislator's 
insight has detected the true principle1
 or has been distorted by ignorance or  
selfishness 7,century ,dict41 ,law74    
,whoever calmly reflects on the manner  
in which laws are enacted by legislative
 bodies1 under the influence of human   
passions and prejudices1 often at the   
dictation of party leaders or of popular
 sentiment1 of office-seekers or wealthy
 corporations1 etc41 will not maintain  
for a moment that human laws and human  
tribunals are to be accepted as the     
supreme measure or norma of right and   
wrong4 ,the common law of ,england1     
which lies at the basis of our ,american
 legislation1 and is an integral portion
 of our civil government1 is less       
fluctuating than our statutory law1 and 
is in the main sound and in conformity  

with the principles of ,jurisprudence4  
,but no one will claim infallibility for
 its enactments2 the esteem we have for 
it is chiefly due to its general accord 
with the requirements of the higher law4
  #g4 ,there is1 then1 a higher law1    
which all men are bound to obey1 even   
lawgivers and rulers themselves as well 
as their humblest subjects1 a law from  
which no man nor class of men can claim 
exemption1 a law which the ,creator     
cannot fail to impose upon ,his rational
 creatures3 although ,god was free to   
create or not to create as ,he chose1   
since ,he did not need anything to      
complete ,his own happiness1--yet1 if   
,he did create1 ,he was bound by ,his   
own wisdom to put order into ,his work2 
else it would not be worthy of ,his     
supreme wisdom4 ,as the poet has so     
tersely expressed it1 ,order is         
,heaven's first law4  ,how admirably is 
this order displayed in the material    
universe6 ,the more we study the        
sciences--astronomy1 biology1 botany1   

physiology1 medicine1 etc4--the more we 
are lost in admiration at the beautiful 
order we see displayed in the tiniest as
 well as in the vastest portions of the 
creation4 ,and shall man alone1 the     
masterpiece of ,god in this visible     
universe1 be allowed to be disorderly1  
to be a failure in the noblest part of  
his being1 to make himself like to the  
brute or to a demon of malice1 to waste 
his choicest gifts in the indulgence of 
debasing pleasure8 ,the ,creator is     
bound by ,his own wisdom to direct men  
to high purposes1 worthy of their       
exalted intellectual nature4 ,but how   
shall ,he direct man8 ,he compels       
material things to move with order to   
the accomplishment of their alloted     
tasks by the physical laws of matter4   
,he directs brute animals most admirably
 to run their appointed careers by the  
wonderful laws of instinct1 which none  
of them can resist at will4 ,but man ,he
 has made free2 ,he must direct him to  
do worthy actions by means suitable to a

 free being1 that is1 by the enacting of
 the moral law4  ,he makes known to us  
what is right and wrong4 ,he informs    
every one of us1 by the voice of reason 
itself1 that ,he requires us to do the  
right and avoid the wrong4 ,he has      
implanted in us the sense of duty to    
obey that law4 ,if we do so1 we lead    
worthy lives1 we please ,him1 and1 in   
,his goodness1 ,he has rewards in store4
  ,but can ,he be pleased with us if we 
thwart ,his designs2 if we1 ,his noblest
 works on earth1 instead of adding to   
the universal harmony of ,his creation1 
make monsters of ourselves1 moral blots 
upon the beautiful face of ,his world8  
,it were idle for ,him to give us the   
knowledge of ,his will and then to stand
 by and let us disfigure ,his fairest   
designs2 to bid us do what is right1 and
 then let us do wrong without exacting  
redress or atonement4 ,if ,he is wise1  
,he must not only lay down the law1 but 
,he must also enforce it2 ,he must make 
it our highest interest to keep ,his    

law1 to do the right2 so that ultimately
 those men shall be happy who have done 
it1 and those who have thwarted ,his    
designs shall be compelled to rue it4   
,he will not deprive us of liberty1 the 
fairest gift to an intelligent creature1
 but ,he will hold out rewards and      
punishments to induce us to keep the law
 and to avoid its violation4 ,once ,he  
has promised and threatened1 ,his       
justice and ,his holiness compel ,him to
 fulfil ,his threats and promises4 ,a   
man can commit no rasher act than to    
ignore1 defy1 and violate that higher   
law of which we are speaking1 and which1
 if it must direct all men1 especially  
requires the respect and obedience of   
those into whose hands he has placed at 
times the lives of their fellow-men1 the
 greatest of earthly treasures4  ,i have
 insisted so much1 gentlemen1 on the    
existence of the higher law1 on its     
binding power and on the necessity of   
observing it1 because it is the         
foundation of my whole course of        

lectures4 ,if there were no higher law1 
then there would be no ,medical         
,jurisprudence1 in the true sense of the
 word4 ,for ,jurisprudence studies the  
principles that underlie legal          
enactments1 and if there were no higher 
law1 there would be no such principles2 
then the knowledge of the human law     
would fill the whole programme4 ,this in
 fact is the contention of the defendant
 of craniotomy to whom ,i have referred2
 and he boldly applies his speculation  
to a matter in which the physician has  
the most frequent opportunity to exhibit
 his fidelity to principle1 or his      
subserviency to the requirements of     
temporary expediency at the sacrifice of
 duty4  #h4 ,you will find1 gentlemen1  
as we proceed in our course1 that       
,doctors have very many occasions in    
which to apply the lessons of           
,jurisprudence in their medical         
practice4 ,i even suspect that they need
 to be more conscientious in regard to  
the dictates of the higher law than any 

other class of men1 the clergy alone1   
perhaps1 excepted4 ,they need this not  
only for their own good1 but also for   
the good of their patients and of the   
community at large4 ,the reasons are    
these3  ,a4 ,the matters entrusted to   
their keeping are the most important of 
all earthly possessions2 for they are   
life itself1 and1 along with life1      
health1 the necessary condition of      
almost all temporal enjoyment4 ,no other
 class of men is entrusted with more    
weighty earthly interests4 ,hence the   
physician's responsibility is very      
great2 hence the common good requires   
that he be eminently faithful and       
conscientious4  ,b4 ,with no other class
 of men does the performance of duty    
depend more on personal integrity1 on   
conscientious regard for the higher law 
of morality than with the ,doctor4 ,for 
the ,doctor's conduct is less open to   
observation than that of other          
professions4 ,the lawyer may have many  
temptations to act unjustly2 but other  

lawyers are watching him1 and the courts
 of justice are at hand to check his    
evil practices4 ,as to the judge1 he is 
to pronounce his decisions in public and
 give reasons for his ruling4 ,the      
politician is jealously watched by his  
political opponents4 ,the public        
functionary1 if he is unjust in his     
dealings1 is likely sooner or later to  
be brought to an account4 ,but the      
physician1 on very many occasions1 can  
be morally sure that his conduct will   
never be publicly scrutinized4 ,such is 
the nature of his ministrations1 and    
such too is the confidence habitually   
reposed in his integrity1 that he is and
 must be implicitly trusted in matters  
in which1 if he happens to be unworthy  
of his vocation1 he may be guilty of the
 most outrageous wrongs4  ,the highest  
interests of earth are in his hands4 ,if
 he is not conscientious1 or if he lets 
himself be carried about by every wind  
of modern speculations1 he can readily  
persuade himself that a measure is      

lawful because it is presently          
expedient1 that acts can justly be      
performed because the courts do not     
punish them2 and thus he will often     
violate the most sacred rights of his   
patients or of their relatives4 ,who has
 more frequent opportunities than a     
licentious ,doctor to seduce the        
innocent1 to pander to the passions of  
the guilty1 to play into the hands of   
greedy heirs1 who may be most willing to
 pay him for his services8 ,no one can  
do it more safely1 as far as human      
tribunals are concerned4 ,as a matter of
 fact1 many1 all over this land and     
other lands1 are often guilty of        
prostituting their noble profession to  
the vilest uses4 ,the evil becomes all  
the more serious when false doctrines   
are insinuated1 or publicly advocated1  
which throw doubt upon the most sacred  
principles of morality4 ,true1 the      
sounder and by far the larger portion of
 medical men protest against these false
 teachings by their own conduct at      

least2 but it very frequently happens   
that the honest man is less zealous in  
his advocacy of what is right than is   
the propagandist of bold speculations   
and dangerous new theories in the       
spreading of what is pernicious4  ,the  
effect thus produced upon many minds is 
to shake their convictions1 to say the  
least2 and ,i need not tell you1        
gentlemen1 that weak convictions are not
 likely to be proof against violent and 
repeated temptations4 ,in fact1 if a    
physician1 misled by any of those many  
theories which are often inculcated or  
at least insinuated by false scientists1
 can ever convince himself1 or even can 
begin to surmise that1 after all1 there 
may be no such thing as a higher law    
before which he is responsible for even 
his secret conduct1 then what is to     
prevent him from becoming a dangerous   
person to the community8 ,if he see much
 temporal gain on the one hand1 and     
security from legal prosecution on the  
other1 what would keep him in the path  

of duty and honesty8 ,especially if he  
can once make himself believe that1 for 
all he knows1 he may be nothing more    
than a rather curiously developed lump  
of matter1 which is to lose forever all 
consciousness in death4 ,why should he  
not get rid of any other evolved lump of
 matter if it stand in the way of his   
present or prospective happiness8 ,those
 are dangerous men who inculcate such   
theories2 it were a sad day for the     
medical profession and for the world at 
large if ever they found much           
countenance among physicians4 ,society  
cannot do without the higher law2 this  
law is to be studied in ,medical        
,jurisprudence4  ,it is my direct       
object1 gentlemen1 to explain this law  
to you in its most important bearings1  
and thus to lay before you the chief    
duties of your profession4 ,the         
principal reason why ,i have undertaken 
to deliver this course of lectures--the 
chief reason1 in fact1 why the          
,creighton ,university has assumed the  

management of this ,medical ,college--is
 that we wish to provide for the ,west1 
as far as we are able1 a goodly supply  
of conscientious physicians1 who shall  
be as faithful and reliable as they will
 be able and well informed2 whose solid 
principles and sterling integrity shall 
be guarantees of upright and virtuous   
conduct4  ,that this task of mine may be
 successfully accomplished1 ,i will     
endeavor to answer all difficulties and 
objections that you may propose4 ,i will
 never consider it a want of respect to 
me as your professor if you will urge   
your questions till ,i have answered    
them to your full satisfaction4 ,on the 
contrary1 ,i request you to be very     
inquisitive2 and ,i will be best pleased
 with those who show themselves the most
 ready to point out those difficulties1 
connected with my lectures1 which seem  
to require further answers and          
explanations4     ,,lecture ,,ii4       
,,craniotomy4   ,gentlemen3--,in my     
first lecture ,i proved to you the      

existence and the binding power of a    
higher law than that of human           
legislators1 namely1 of the eternal law1
 which1 in ,his wisdom1 the ,creator1 if
 ,he created at all1 could not help     
enacting1 and which ,he is bound by ,his
 wisdom and justice to enforce upon     
mankind4  ,we are next to consider what 
are the duties which that higher law    
imposes upon the physician4 ,in this    
present lecture ,i will confine myself  
to one duty1 that of respect for human  
life4  ,a duty is a bond imposed on our 
will4 ,god1 as ,i remarked before1      
imposes such bonds1 and by them ,he     
directs free beings to lead worthy      
lives4 ,as ,he directs matter by        
irresistible physical laws1 so ,he      
directs intelligent and free beings by  
moral laws1 that is1 by laying duties or
 moral bonds upon them1 which they ought
 to obey1 which ,he must require them to
 obey1 enforcing ,his commands by       
suitable rewards and punishments4 ,thus 
,he establishes and enforces the moral  

order4  ,now the duties ,he lays upon us
 are of three classes4 ,first1 there are
 duties of reverence and honor towards  
,himself as our sovereign ,lord and     
,master4 ,these are called the duties of
 ,religion1 the study of which does not 
belong to ,medical ,jurisprudence4 ,the 
other classes of duties regard ourselves
 and our fellow-men1 with these we are  
to deal in our lectures4  ,i4 ,order    
requires that the meaner species of     
creatures shall exist for the benefit of
 the nobler2 the inert clod of earth    
supports vegetable life1 the vegetable  
kingdom supplies the wants of animal    
life1 the brute animal with all inferior
 things subserves the good of man2 while
 man1 the master of the visible         
universe1 himself exists directly for   
the honor and glory of ,god4 ,in this   
beautiful order of creation1 man can use
 all inferior things for his own        
benefit4  ,this is what reason teaches  
concerning our status in this world2 and
 this teaching of reason is confirmed by

 the convictions of all nations and all 
ages of mankind4 ,the oldest page of    
literature that has come down to us1    
namely1 the first chapter of the first  
book of ,holy ,writ1 lays down this same
 law1 and no improvement has been made  
in it during all subsequent ages4       
,whether we regard this writing as      
inspired1 as ,christians and ,jews have 
always done1 or only as the testimony of
 the most remote antiquity1 confirmed by
 the acceptance of all subsequent       
generations1 it is for every sensible   
man of the highest authority4  ,here is 
the passage3 ,god said1 ,let us make man
 to our image and likeness2 and let him 
have dominion over the fishes of the    
sea1 and the fowls of the air1 and the  
beasts1 and the whole earth1 and every  
creeping creature that creepeth upon the
 earth4 ,and later on in history1 after 
the deluge1 ,god more explicitly        
declared the order thus established1    
saying to ,noe and his posterity3 ,every
 thing that moveth and liveth shall be  

meat for you2 even as the green herbs   
have ,i delivered them to you4 ,but ,he 
emphatically adds that the lives of men 
are not included in this grant2 they are
 directly reserved for ,his own         
disposal4 ,at the hand of every man1 ,he
 says1 will ,i require the life of man4 
,all things then are created for man2   
man is created directly for ,god1 and is
 not to be sacrificed for the advantage 
of a fellow-man4 ,thus reason and       
,revelation in unison proclaim that we  
can use brute animals as well as plants 
for our benefit1 taking away their lives
 when it is necessary or useful to do so
 for our own welfare2 while no man is   
ever allowed to slay his fellow-man for 
his own use or benefit3 ,at the hand of 
every man will ,i require the life of   
man4  ,,ii4 ,the first practical        
application ,i will make of these       
general principles to the conduct of    
physicians is this3 a physician and a   
student of medicine can1 with a safe    
conscience1 use any brute animal that   

has not been appropriated by another    
man1 whether it be bug or bird or beast1
 to experiment upon1 whatever specious  
arguments humane societies may advance  
to the contrary4 ,brute animals are for 
the use of man1 for his food and        
clothing1 his mental and physical       
improvement1 and even his reasonable    
recreations4 ,man can lawfully hunt and 
fish and practise his skill at the      
expense of the brute creation1          
notwithstanding the modern fad of       
sentimentalists4 ,the teacher and the   
pupil can use vivisection1 and thus to  
some extent prolong the sufferings of   
the brute subject for the sake of       
science1 of mental improvement1 and     
intelligent observation4 ,but is not    
this cruelty8 and has a man a right to  
be cruel8 ,no man has a right to be     
cruel2 cruelty is a vice1 it is         
degrading to man's noble nature4 ,but   
vivisection practised for scientific    
purposes is not cruel4 ,cruelty implies 
the wanton infliction of pain3 there are

 people who delight in seeing a victim  
tortured2 this is cruelty or savagery1  
and is a disgrace to man4 ,even to      
inflict pain without benefit is cruel   
and wrong2 but not when it is inflicted 
on the brute creation for the benefit of
 man1 unless the pain should be very    
great and the benefit very small4       
,certainly it is right to cultivate     
habits of kindness even to animals2 but 
this matter must not be carried to      
excess4  ,the teaching of humane        
societies condemning all vivisection is 
due to the exaggeration of a good       
sentiment and to ignorance of first     
principles4 ,for they suppose that      
sufferings inflicted on brute animals   
are a violation of their rights4 ,now we
 maintain that brute animals have no    
rights in the true sense of the word4   
,to prove this thesis we must explain   
what a right is and how men get to have 
rights4 ,a right is a moral claim to a  
thing1 which claim other persons are    
obliged to respect4 ,since every man has

 a destiny appointed for him by his     
,creator1 and which he is to work out by
 his own acts1 he must have the means   
given him to do so4 ,for to assign a    
person a task and not to give him the   
means of accomplishing it would be      
absurd4 ,therefore the ,creator wants   
him to have those means1 and forbids    
every one to deprive him of those means4
 ,here is the foundation of rights4     
,every man1 in virtue of the ,creator's 
will1 has certain advantages or claims  
to advantages assigned him which no     
other man may infringe4 ,those          
advantages and claims constitute his    
rights1 guaranteed him by the ,creator2 
and all other men have the duty imposed 
on them to respect those rights4 ,thus  
rights and duties are seen to be        
correlative and inseparable2 the rights 
lodged in one man beget duties in other 
men4 ,the same ,creator that assigns    
rights to one man lays upon all others  
duties to respect those rights1 that    
thus every free being may have the means

 of working out its ,heaven-appointed   
destiny4  ,thus it is apparent that     
rights and duties suppose free beings1  
persons2 now an irrational animal is not
 a person2 it is not a free being1      
having a destiny to work out by its free
 acts2 it is therefore incapable of     
having duties4 ,duties are matters of   
conscience2 therefore they cannot belong
 to the brute animal2 for it has no     
conscience4 ,and1 since rights are given
 to creatures because of the duties     
incumbent on them1 brute animals are    
incapable of having rights4 ,when a     
brute animal has served man's purpose1  
it has reached its destiny4  ,,iii4 ,but
 it is entirely different with man3     
there is what we may call an infinite   
distance between man and brute4 ,every  
man is created directly for the honor   
and service not of other men1 but of    
,god ,himself3 by serving ,god man must 
work out his own destiny--eternal       
happiness4 ,in this respect all men are 
equal1 having the same essence or nature

 and the same destiny4 ,the poor child  
has as much right to attain eternal     
happiness as the rich child1 the infant 
as much as the gray-bearded sire4 ,every
 one is only at the beginning of an     
endless existence1 of which he is to    
determine the nature by his own free    
acts4 ,in this infinite destiny lies the
 infinite superiority of man over the   
brute creation4  ,that all men are equal
 in their essential rights is the       
dictate of common-sense and of sound    
philosophy4 ,this truth may not flatter 
kings and princes2 but it is the charter
 of human rights1 founded deeper and    
broader in nature and on the ,creator's 
will than any other claim of mankind4   
,as order requires the subordination of 
lower natures to higher1 so it requires 
equality of essential rights among      
beings of the same nature4 ,now all men 
are of the same nature1 hence they have 
all the same essential rights4  ,if any 
people on earth must stand by these     
principles1 certainly the ,american     

people must do so2 for we have put them 
as the foundation-stones of our civil   
liberty4 ,there is more wisdom than     
many1 even of its admirers1 imagine in  
the preamble to our ,declaration of     
,independence2 upon it we are to base   
the most important rights and duties    
which belong to ,jurisprudence4 ,the    
words of the preamble read as follows3  
,we hold these truths as self-evident1  
that all men are created equal2 that    
they are endowed by their ,creator with 
certain inalienable rights2 that among  
these are life1 liberty1 and the pursuit
 of happiness4 ,i feel convinced1       
gentlemen1 and ,i will take it for      
granted henceforth1 unless you bring    
objections to the contrary1 that you all
 agree with me on this important point  
that every man has a natural right to   
his life1 a right which all other men   
are solemnly bound to respect4 ,it is   
his chief earthly right4 ,it is called  
an inalienable right2 by which term the 
fathers of our liberty meant a right    

which under no circumstances can be     
lawfully disregarded4 ,a man who takes  
it upon himself to deprive another of   
life commits two grievous wrongs3 one   
towards his victim1 whose most important
 right he violates1 and one towards     
,god1 who has a right to the life and   
service of ,his creatures4 ,thou shalt  
not kill is a precept as deeply engraven
 on the human heart by reason itself as 
it was on the stone tables of the ,ten  
,commandments by ,revelation4  ,so far  
we have chiefly considered murder as a  
violation of man's right to his life4   
,we must now turn our attention to      
,god's right1 which the murderer        
violates4 ,it may indeed happen that a  
man willingly resigns his right to live1
 that he is tired of life1 and longs and
 implores for some one to take it away4 
,can you then do it8 ,you cannot4 ,his  
life does not belong to him alone1 but  
to ,god also1 and to ,god principally2  
if you destroy it1 you violate ,god's   
right1 and you will have to settle with 

,him4 ,god wills this man to live and   
serve ,him1 if it were only by patient  
endurance of his sufferings4  ,for a man
 may be much ennobled and perfected by  
the practice of patience under pain and 
agony4 ,some of the noblest characters  
of history are most glorious for such   
endurance4 ,the suicide rejects this    
greatness2 he robs ,god of service and  
glory1 he rebels against his ,creator4  
,even ,plato of old understood the      
baseness of suicide1 when he wrote in   
his dialogue called ,phdon that a man in
 this world is like a soldier stationed 
on guard2 he must hold his post as long 
as his commander requires it2 to desert 
it is cowardice and treachery2 thus1 he 
says1 suicide is a grievous crime4      
,this being so1 can a ,doctor1 or any   
other man1 ever presume to contribute   
his share to the shortening of a        
person's life by aiding him to commit   
suicide8 ,we must emphatically say ,no1 
even though the patient should desire   
death3 the ,doctor cannot1 in any case1 

lend his assistance to violate the right
 and the law of the ,creator3 ,thou     
shalt not kill4  ,i have no doubt1      
gentlemen1 that some of you have been   
saying to yourselves1 ,why does the     
lecturer insist so long upon a point    
which is so clear8 ,of course1 none of  
us doubts that we can in no case aid a  
patient to commit suicide4 ,my reason   
for thus insisting on this matter is    
that here again we are dealing with a   
living issue4 ,there are to-day         
physicians and others who deny this     
truth1 not in their secret practice     
only1 but1 of late1 to justify their    
conduct1 they have boldly formulated the
 thesis that present apparent expediency
 can lawfully be preferred to any higher
 consideration4 ,here is the fact4 ,at a
 ,medico-,legal ,congress1 held in the  
summer of #ahie1 ,dr4 ,bach1 one of its 
leading lights1 openly maintained it as 
his opinion that ,physicians have the   
moral right to end life when the disease
 is incurable1 painful1 and agonizing4  

,what his arguments were in support of  
his startling proposition1 ,i have not  
been able to learn4 ,but ,i know that a 
cry of horror and indignation has gone  
up from many a heart4 ,many have        
protested in print2 but unless1 on an   
occasion like this1 moralists raise     
their voice against it with all the     
influence which sound principles        
command1 the saying of ,dr4 ,bach may at
 least shake the convictions of the     
rising generation of physicians4 ,the   
only argument for ,dr4 ,bach's assertion
 that ,i can imagine--and it is one     
proceeding from the heart rather than   
the head--is that it is cruel to let a  
poor man suffer when there is no longer 
hope of recovery4 ,it is not the        
,physician that makes him suffer2 it is 
,god who controls the case1 and ,god is 
never cruel4  ,he knows ,his own        
business1 and forbids you to thwart ,his
 designs4 ,if the sufferer be virtuous1 
,god has an eternity to reward his      
patient endurance2 if guilty1 the ,lord 

often punishes in this world that ,he   
may spare in the next4 ,let ,him have   
,his way1 if you are wise2 ,his command 
to all is clear1 ,thou shalt not kill4  
,one rash utterance1 like that of ,dr4  
,bach1 can do an incalculable amount of 
harm4 ,why1 gentlemen1 just think what  
consequences must follow if his         
principle were1 admitted6 ,for the only 
reason that could give it any           
plausibility would be that the patient's
 life is become useless and             
insupportable4 ,if that were a reason   
for taking human life away1 then it     
would follow that1 whenever a man       
considers his life as useless and no    
longer supportable1 he could end it1 he 
could commit suicide4 ,that reasoning   
would practically justify almost all    
suicides4 ,for1 when people kill        
themselves1 it is1 in almost all cases1 
because they consider their lives       
useless and insupportable4 ,whether it  
results from physical or from moral     
causes that they consider their life a  

burden1 cannot1 it seems to me1 make any
 material difference2 grief1 shame1     
despair are as terrible sufferings as   
bodily pains4 ,if1 then1 we accept ,dr4 
,bach's principle1 we must be prepared  
for all its baneful consequences4  ,,iv4
 ,but are there no exceptions to the    
general law1 ,thou shalt not kill8 ,are 
there no cases in which it is allowed to
 take another's life8 ,what about       
justifiable homicide8 ,there are three  
cases of this nature1 gentlemen2 namely1
 self-defence1 capital punishment       
inflicted by the state1 and active      
warfare4 ,with only one of these can a  
physician1 as such be concerned or think
 himself concerned4 ,he is not a public 
hangman executing a sentence of a       
criminal court2 nor is he acting as a   
soldier proceeding by public authority  
against a public foe4 ,as to the plea of
 self-defence1 it must be correctly     
understood1 lest he usurp a power which 
neither human nor divine law has        
conferred upon him4  #a4 ,self-defence4 

,it is a dictate of common-sense1       
already quoted by ,cicero as a          
universally received maxim of           
,jurisprudence in his day1 that it is   
justifiable to repel violence by        
violence1 even if the death of our      
unjust assailant should result4 ,in such
 a case1 let us consider what really    
takes place4 ,a ruffian attempts to take
 away my life2 ,i have a right to my    
life4 ,i may1 therefore1 protect it     
against him2 and1 for that purpose1 ,i  
may use all lawful means4 ,a lawful     
means is one that violates no law1 one  
that ,i may use without giving any one  
reasonable ground of complaint4 ,suppose
 ,i have no other means to protect my   
life than by shooting my aggressor2 has 
he a right to complain of my conduct if 
,i try to do so8 ,no1 because he forces 
me to the act2 he forces me to choose   
between my life and his4 ,good order is 
not violated if ,i prefer my own life3  
well-ordered charity begins at home4    
,but is not ,god's right violated8 ,it  

is2 for ,god has a right to my life and 
to that of my assailant4 ,the ruffian   
who compels me to shoot him is to blame 
for bringing both our lives into danger2
 he is responsible for it to ,god4 ,but 
the ,creator will not blame me for      
defending my life by the only means in  
my power1 and that when compelled by an 
unjust assailant1 who cannot reasonably 
find fault with my conduct4  ,but it may
 be objected that no evil act may be    
done to procure a good result1 that a   
good end does not justify a bad means4  
,that is a correct principle1 and we    
will consider it carefully some other   
day4 ,but my act of necessary           
self-defence is not evil1 and therefore 
needs no justification2 for the means ,i
 employ are1 under the circumstances1   
well-ordered and lawful means1 which    
violate no one's rights1 as has just    
been shown4 ,of course the harm ,i do to
 the aggressor is just only in as far as
 it is strictly necessary to defend the 
inalienable right ,i have to life or    

limb or very valuable property4 ,hence  
,i must keep within the just limits of  
self-defence4 ,to shoot an assailant1   
when ,i am in no serious danger1 or when
 ,i can free myself some other way1 or  
when ,i act through malice1 would not be
 self-defence1 but unjustifiable        
violence on my part4  #b4 ,the          
principles that make it lawful for a man
 to defend his own life with violence   
against an unjust assailant will also   
justify a parent in thus defending his  
children1 a guardian his wards2 and in  
fact any one may forcibly defend any    
other human being against unjust        
violence4 ,a parent or guardian not only
 can1 but he is in duty bound to1 defend
 those under his charge by all lawful   
means4 ,similarly the physician would be
 obliged to defend his patient by the   
exercise of his profession in his       
behalf4  ,now the only case in which the
 need of medical treatment against      
unjust aggression could become a matter 
for discussion in ,jurisprudence is the 

case of a mother with child4 ,is the    
child under those circumstances really  
an unjust aggressor8 ,let us study that 
important case with the closest         
attention4 ,let all the rays of light we
 have gathered so far be focussed on    
this particular point4 ,can a physician 
ever be justified in destroying the life
 of a child1 before or during its birth1
 by craniotomy or in any other manner1  
in order to save its mother's life1 on  
the plea that the child is an unjust    
assailant of the life of its mother8    
,put the case in a definite shape before
 you4 ,here is a mother in the pangs of 
parturition4 ,an organic defect1 no     
matter in what shape or form1 prevents  
deliverance by the ordinary channels4   
,all that medical skill can do to assist
 nature has been done4 ,the case is     
desperate4 ,other physicians have been  
called in for consultation1 as the civil
 law requires before it will tolerate   
extreme measures4 ,all agree that1 if no
 surgical operation is performed1 both  

mother and child must die4 ,there are   
the ,csarian section1 the ,porro        
operation1 laparotomy1 symphysiotomy1   
all approved by science and the moral   
law4 ,but we will suppose an extreme    
case2 namely1 the circumstances are so  
unfavorable for any of these            
operations--whether owing to want of    
skill in the ,doctors present1 or for   
any other reason--that none can safely  
be attempted2 any of them would be fatal
 to the mother4  ,in this extreme case  
of necessity1 can the ,doctor break the 
cranium of the living child1 or in any  
way destroy its life with a view to save
 the mother8 ,if three consulting       
physicians agree that this is the only  
way to save her1 he will not be molested
 by the law courts for performing the   
murderous operation4 ,but will the law  
of nature and of nature's ,god approve  
or allow his conduct8 ,this is the      
precise question under our              
consideration4 ,we have seen that the   
infant1 a true human being1 has a right 

to live1 as well as its mother4 ,all men
 are created equal1 and have an equal   
right to life1 declares the first       
principle of our liberty4 ,the ,creator1
 too1 as reason teaches1 has a clear    
right to the child's life2 that child   
may answer a very special purpose of    
,providence4 ,but whether it will or    
not1 ,god is the supreme and the only   
,master of life and death1 and ,he has  
laid down the strict prohibition1 ,thou 
shalt not kill4  ,now comes the plea of 
self-defence against an unjust          
aggressor4 ,if the child is such1 if it 
unjustly attacks its mother's life1 then
 she can destroy it to save herself1 and
 her physician can aid the innocent     
against the guilty party4 ,but can it be
 proved that the infant is an unjust    
aggressor in the case8 ,there can be no 
intentional or formal guilt in the      
little innocent babe4 ,but can we argue 
that the actual situation of the child  
is an unjust act1 unconsciously done1   
yet materially unjust1 unlawful8 ,thus1 

if a madman would rush at me with a     
sharp sword1 evidently intent on killing
 me1 he may be called an unjust         
aggressor2 though1 being a raving       
maniac1 he does not know what crime he  
is committing1 and is formally innocent 
of murderous intent4 ,materially        
considered1 the act is unjust1 and ,i   
can defend myself lawfully as against   
any other unjust assailant4 ,such is the
 common teaching of moralists4 ,but can 
the innocent babe be classed in the same
 category with the raving maniac8 ,why  
should it8 ,it is doing nothing2 it is  
merely passive in the whole process of  
parturition4  ,will any one object that 
the infant has no right to be there at  
all8 ,who put it there8 ,the only human 
agents in the matter were its parents4  
,the mother is more accountable for the 
unfortunate situation than the child4   
,certainly you could not1 to save the   
child1 directly kill the mother1        
treating her as an unjust assailant of  
her child's life8 ,still less can you   

treat the infant as an unjust assailant 
of its mother's life4  ,the plea of     
self-defence against unjust aggression  
being thus ruled out of court in all    
such cases1 and no other plea remaining 
for the craniotomist1 we have           
established1 on the clearest principles 
of ,ethics and ,jurisprudence1 that it  
is never allowed directly to kill a     
child as a means to save its mother's   
life4 ,it would be a bad means1 morally 
evil2 and no moral evil can ever be done
 that good may come of it2 the end      
cannot justify an evil means4 ,in theory
 all good men agree with us that the end
 can never justify the means4 ,but in   
practice it seems to be different with  
some of the medical profession4 ,of     
late1 however1 the practice of          
craniotomy and all equivalent operations
 upon living subjects has gone almost   
entirely out of fashion among the better
 class of physicians4  ,allow me1       
gentlemen1 to conclude this lecture with
 the reading of two extracts from       

articles of medical writers on the      
present state of craniotomy in their    
profession4 ,you will find them in      
accord with the conclusions at which we 
have arrived by reasoning upon the      
principles of ,jurisprudence4  ,dr4 ,w4 
,h4 ,parish writes 7,am4 ,eccles4       
,review1 ,november1 #ahic1 p4 #cfd73    
,the operations of craniotomy and       
embryotomy are to-day of relatively     
infrequent occurrence1 and many         
obstetricians of large experience have  
never performed them4 ,advanced         
obstetricians advocate the performance  
of the ,cesarian section or its         
modification--the ,porro operation--in  
preference to craniotomy1 because nearly
 all the children are saved1 and the    
unavoidable mortality among mothers is  
not much higher than that which attends 
craniotomy4 ,of one hundred women on    
whom ,cesarian section is performed     
under favorable conditions and with     
attainable skill1 about ninety-five     
mothers should recover and fully the    

same number of children4 ,of one hundred
 craniotomies1 ninety-five mothers or   
possibly a larger number will recover1  
and of course none of the children4 ,the
 problem resolves itself into this3     
,which shall we choose--,cesarian       
section with one hundred and ninety     
living beings as the result1 or         
craniotomy with about ninety-five living
 beings8  ,even if a liberal deduction  
be made for unfavorable circumstances   
and deficient skill1 the results1       
gentlemen1 will still leave a wide      
margin in favor of ,cesarian section4   
,my second extract is from an article of
 ,dr4 ,m4 ,o',hara1 and it is supported 
by the very highest authorities 7ib4 p4 
#cfa73 ,recently ,august #a1 #ahic the  
,british ,medical ,association1 the most
 authoritative medical body in ,great   
,britain1 at its sixty-first annual     
meeting1 held at ,newcastle-upon-,tyne1 
definitely discussed the subject before 
us4 ,in the address delivered at the    
opening of the section of ,obstetric    

,medicine and ,gynecology1 an assertion 
was put forth which ,i regard as very   
remarkable1 my recollection not taking  
in any similar pronouncement made in any
 like representative medical body4 ,the 
authoritative value of this statement1  
accepted as undisputed by the members of
 the association1 which counts about    
fifteen thousand practitioners1 need not
 be emphasized4  ,dr4 ,james ,murphy    
7',british ,medical ,journal1' ,august  
#bf1 #ahic71 of the ,university of      
,durham1 made the presidential address4 
,he first alluded to the perfection to  
which the forceps had reached for pelves
 narrowed at the brim1 and the means of 
correcting faulty position of the ftus  
during labor4 ,he then stated3 ',in     
cases of great deformity of the pelvis1 
it has long been the ambition of the    
obstetrician1 where it has been         
impossible to deliver a living child per
 vias naturales1 to find some means by  
which that child could be born alive    
with comparative safety to the mother2  

and that time has now arrived4 ,it is   
not for me to decide1' he says1 'whether
 the modern ,cesarian section1 ,porro's 
operation1 symphysiotomy1               
ischiopubotomy1 or other operation is   
the safest or most suitable1 nor yet is 
there sufficient material for this      
question to be decided2 but when such   
splendid and successful results have    
been achieved by ,porro1 ,leopold1      
,saenger1 and by our own ,murdoch       
,cameron1 ,i say it deliberately and    
with whatever authority ,i possess1 and 
,i urge it with all the force ,i can    
master1 that we are not now justified in
 destroying a living child2 and while   
there may be some things ,i look back   
upon with pleasure in my professional   
career1 that which gives me the greatest
 satisfaction is that ,i have never done
 a craniotomy on a living child4'  ,you 
will please notice1 gentlemen1 that when
 this distinguished ,doctor said1 ,we   
are not now justified in destroying a   
living child1 he was speaking from a    

medical standpoint1 and meant to say    
that such destruction is now            
scientifically unjustifiable1 is a      
blunder in surgery4 ,from a moral point 
of view it is not only now1 but it was  
always1 unjustifiable to slay a child as
 a means to save the mother's life2 a   
good end cannot justify an evil means1  
is a truth that cannot be too           
emphatically inculcated4 ,this is one of
 the most important subjects on which   
,medical ,jurisprudence has been        
improved1 and most of its text-books are
 deficient4 ,the improvement is         
explained with much scientific detail in
 an address of the ,president1 ,samuel  
,c4 ,busey1 ,m4,d41 before the          
,washington ,obstetrical and            
,gynecological ,society 7,am4 ,journal  
of ,obstetrics and ,diseases of ,women  
and ,children1 vol4 xvii4 n4 #b74       
,,lecture ,,iii4  ,,abortion4           
,abortion1 gentlemen1 is the theme of my
 present lecture4  ,i4 ,an important    
point to be determined is the precise   

time when the human embryo is first     
animated by its own specific principle  
of life1 its human soul4 ,it is         
interesting to read what various        
conjectures have been ventured on this  
subject by the learned of former ages4  
,they were totally at sea4 ,though      
gifted with keen minds1 they had not the
 proper data to reason from4 ,and yet   
some of those sages made very shrewd    
guesses4 ,for instance1 as early as the 
fourth century of our era1 ,st4 ,gregory
 of ,nyssa taught the true doctrine1    
which modern science has now universally
 accepted4 ,he taught that the rational 
soul is created by ,almighty ,god and   
infused into the embryo at the very     
moment of conception4 ,still1 as ,st4   
,gregory could not prove the certainty  
of his doctrine1 it was opposed by the  
majority of the learned4  ,the          
,schoolmen of the ,middle ,ages1 while  
condemning abortion from the time of    
conception1 preferred the opinion of    
,aristotle1 that the rational soul is   

not infused till the ftus is            
sufficiently developed to receive it4   
,the embryo lived first1 they taught1   
with a vegetable life2 after a few days 
an animal soul replaced the vegetative  
principle2 the human soul was not       
infused into the tiny body till the     
fortieth day for a male1 and the        
eightieth day for a female child4 ,all  
this sounds very foolish now2 and yet we
 should not sneer at their ignorance2   
had we lived in their times1 we could   
probably have done no better than they4 
,it was not till #afbj that ,fienus1 a  
physician of ,louvain1 in ,belgium1     
published the first book of modern times
 that came near the truth4 ,he          
maintained that the human soul was      
created and infused into the embryo     
three days after conception4 ,nearly    
forty years later1 in #afeh1 a religious
 priest1 called ,florentinius1 wrote a  
book in which he taught that1 for all we
 know1 the soul may be intellectual or  
human from the first moment of          

conception2 and the ,pope's physician   
,zachias soon after maintained the      
thesis as a certainty that the human    
embryo has from the very beginning a    
human soul4  ,great writers applauded   
,fienus and his successors2 universities
 favored their views2 the ,benedictines1
 the ,dominicans1 and the ,jesuits      
supported them4 ,modern science claims  
to have proved beyond all doubt that the
 same soul animates the man that        
animated the ftus from the very moment  
of conception4 ,the ,medical            
,jurisprudence of ,wharton and ,still   
quotes ,dr4 ,hodge of the ,pennsylvania 
,university as follows 7p4 #aa73 ,in a  
most mysterious manner brought into     
existence1 how wonderful its formation6 
,imperfect in the first instance1 nay1  
even invisible to the naked eye1 the    
embryo is nevertheless endowed1 at once1
 with the principles of vitality2 and   
although retained in the system of its  
mother1 it has1 in a strict sense1 an   
independent existence4 ,it immediately  

manifests all the phenomena of organic  
life2 it forms its own fluids and       
circulates them2 it is nourished and    
developed2 and1 very rapidly from being 
a rudis indigestaque moles1 apparently  
an inorganic drop of fluid1 its organs  
are generated and its form perfected4   
,it daily gains strength and grows2 and1
 while still within the organ of its    
mother1 manifests some of the phenomena 
of animal life1 especially as regards   
mobility4 ,after the fourth month its   
motions are perceptible to the mother1  
and in a short period can be perceived  
by other individuals on close           
investigation4  ,the usual impression1  
the authors add1 and one which is       
probably still maintained by the mass of
 the community1 is that the embryo is   
perfected at the period of              
quickening--say the one hundred and     
twelfth or one hundred and twentieth    
day4 ,when the mother first perceives   
motion1 is considered the period when   
the ftus becomes animated--when it      

receives its spiritual nature into union
 with its corporeal4  ,these and similar
 suppositions are1 as has been already  
shown1 contrary to all fact1 and1 if it 
were not for the high                   
authorities--medical1 legal1 and        
theological--in opposition1 we might    
add1 to common-sense4  ,at present1     
gentlemen1 there seems to be no longer  
any authority to the contrary4 ,but many
 people1 and some ,doctors1 seem to be  
several generations behind the times2   
for they still act and reason as if in  
the first weeks of pregnancy no immortal
 or human soul were in question4        
,physicians worthy of their noble       
profession should strive to remove such 
gross and mischievous ignorance4 ,in    
many of the ,united ,states the law     
casts its protection around an unborn   
infant from its first stage of          
ascertainable existence2 no matter      
whether quickening has taken place or   
not1 and consequently no matter what may
 be the stage of gestation1 an          

indictment lies for its wilful          
destruction 7,wharton and ,still1 p4    
#hfa74 ,where there has been as yet no  
judicial settlement of the immediate    
question1 it may be reasonably contended
 that to make the criminality of the    
offence depend upon the fact of         
quickening is as repugnant to sound     
morals as it is to enlightened          
physiology 7ib474 ,that it is           
inconsistent with the analogies of the  
law is shown by the fact that an infant1
 born even at the extreme limit of      
gestation after its father's death1 is  
capable of taking by descent1 and being 
appointed executor 7ib474 ,dr4 ,hodge   
adds this sensible remark3 ,it is then  
only at conception the father can in any
 way exert an influence over his        
offspring2 it is then only the female   
germ is in direct union with the        
mother--the connection afterwards is    
indirect and imperfect 7ib474 ,the fact1
 therefore1 is now scientifically       
established that the embryo from the    

first moment of conception or           
fecundation is a human being1 having a  
human immortal soul4  ,,ii4 ,now we come
 to the direct study of abortion4       
,abortion1 or miscarriage1 strictly     
means the expulsion of the ftus before  
it is viable1 i4e41 before it is        
sufficiently developed to continue its  
life outside of the maternal womb4 ,the 
period of arrival at viability is       
usually after the twenty-eighth week of 
gestation4 ,when birth occurs later than
 that period1 and yet before the full   
term of nine months1 it is called       
premature birth1 which is altogether    
different from abortion2 for it may save
 the life of the child1 which abortion  
always destroys4 ,premature labor is    
frequently induced in legitimate medical
 practice1 for the purpose of avoiding  
the risks which in some cases attend    
parturition at term4444 ,the average    
number of children saved by this means  
is rather more than one-half of the     
cases operated upon1 say ,wharton and   

,still 7,parturition1 p4 #if74 ,but they
 caution the physician against too ready
 recourse to this treatment2 for1 they  
add very truly1 ,the sympathetic        
phenomena of pregnancy are often more   
alarming in appearance than in reality1 
and will rarely justify any interference
 with the natural progress of gestation4
 ,in all cases the physician should     
consult with one or more of his         
colleagues before inducing premature    
labor2 in this manner his humane        
intentions will not expose him1 in case 
of failure1 to reproach1 suspicion1 or  
prosecution4  ,the first time my        
attention was practically called to the 
case of a child in danger of dying      
before the time of delivery occurred    
over twenty years ago1 when the mother  
of a highly respected family1 then in my
 spiritual charge1 was wasting away with
 consumption during her state of        
pregnancy4 ,you know that we ,catholics 
are very solicitous that infants shall  
not die without ,baptism1 because we    

believe that heaven is not promised to  
the unbaptized4 ,i therefore directed   
the lady's husband to consult their     
family physician on the prospects of the
 case1 and take timely precautions1 so  
that1 if death should come on the mother
 before her delivery1 the infant might  
be reached at once and be baptized      
before it expired4 ,the physician1 a    
learned and conscientious practitioner1 
answered that we should not be          
solicitous2 for that ,nature had so     
provided that mothers in such cases     
rarely die before the child is born4 ,he
 was right4 ,the child was born and     
baptized2 the mother died a few hours   
later2 the little one lived several     
weeks before it went to join the angels 
in heaven4 ,i learned from that         
occurrence the lesson which ,wharton and
 ,still inculcate that the phenomena of 
pregnancy are often far more alarming in
 appearance than in reality1 and we are 
rarely justified in interfering with the
 natural progress of gestation4  ,to    

return to our subject4 ,abortion1 or    
miscarriage1 is often1 as you know1     
gentlemen1 the result of natural causes 
beyond human control2 at other times it 
is brought on by unintentional          
imprudence on the part of the mother or 
her attendants4 ,it is the duty of the  
family physician1 when occasions offer1 
to instruct his pregnant patients and   
other persons concerned on the dangers  
to be avoided4 ,a good ,doctor should be
 to his patients what a father is to his
 children2 very important matters are   
confided to him1 and therefore grave    
responsibilities rest on his conscience4
  ,,iii4 ,we are now ready to consider  
the chief question of this lecture1     
namely1 whether there can be any cases  
in which a physician is justified in    
bringing about an abortion1 or in       
prescribing a treatment from which he   
knows an abortion is likely to result4  
#a4 ,it is evident that1 if he acts with
 due prudence1 and yet1 from some cause 
which he did not foresee and could not  

have been foreseen1 his treatment brings
 about a miscarriage1 he cannot justly  
be held accountable for what he could   
not help4  #b4 ,but what if he foresees 
that a drug or treatment1 which1 he     
thinks1 is needed for the mother's      
health1 may perhaps bring on a          
miscarriage8 ,can he still administer   
that drug or prescribe that treatment8  
,notice the question carefully4 ,it is  
not supposed that he wants to bring on  
the miscarriage4 ,he does not2 he will  
do all he can to prevent it4 ,nor will  
his treatment or drug directly destroy  
the life or the organism of the embryo2 
but it is intended to affect favorably  
the system of the mother1 and it is     
applied to her own organism4 ,still the 
,doctor knows that the prescription may 
indirectly bring about abortion4 ,can he
 prescribe the drug or treatment from   
which he knows the death of the ftus may
 indirectly result1 the direct purpose  
being to remove an ailment of the       
mother's8  ,there is a sound moral      

principle bearing on such cases2 it is  
universally admitted in ,ethics and     
,jurisprudence1 and its application is  
so extensive that it well deserves      
careful study4 ,it is this3 ,he who     
wilfully puts a cause is answerable for 
the effect of that cause1 causa caus est
 causa causati4 ,therefore1 if the      
effect is evil1 he is answerable for    
that evil4 ,this1 however1 supposes that
 he could foresee the danger of such    
evil effect4  ,that evil effect is said 
to be indirectly willed2 for it follows 
from a cause which is directly willed4  
,if1 then1 you should give a dose to a  
pregnant mother which is intended to    
stop her fever or other ailment1 but may
 also bring on abortion1 the stopping of
 her fever is directly intended1 and the
 abortion is said to be indirectly      
intended or willed4 ,those are the      
received terms in moral science4 ,it    
were more correct to say that the       
abortion in this case is an effect not  
intended at all1 but only permitted4    

,that1 then1 which is permitted to      
result from our acts is said to be      
indirectly willed4  ,are we then always 
responsible for evil effects permitted  
or indirectly willed8 ,the principle    
laid down seems to say so4 ,but then    
that principle admits of important      
exceptions4 ,if we could never do an act
 from which we know evil consequences   
may follow1 then we could scarcely do   
anything of importance2 a young man     
could certainly not become a physician  
at all1 for he is almost certain to     
injure some of his patients in the      
course of his professional life4 ,but if
 we had no ,doctors1 such a loss would  
be a much greater evil to mankind than  
their occasional mistakes4 ,here then we
 seem to be in a dilemma1 with evil on  
both sides of us4 ,and then we are      
reminded of that other principle of     
which we spoke before1 that we may never
 do evil at all that good may come of   
it4 ,what shall we do8 ,the solution is 
this3 we should never do evil1 but we   

are often justified in permitting evil  
to happen2 in other words1 we can never 
will evil directly1 but we can often    
will it indirectly3 we can do what is   
right in itself1 even though we know or 
fear that evil will also result from our
 good act4  ,this conduct requires four 
conditions3 #a4 ,that we do not wish the
 evil itself1 but make all reasonable   
effort to avoid it4 #b4 ,that the       
immediate effect we wish to produce is  
good in itself4 #c4 ,that the good      
effect intended is at least as important
 as the evil effect permitted4 #d4 ,that
 the evil is not made a means used to   
obtain the good effect4  ,now let us    
apply these principles to the case in   
hand4  #a4 ,if the medicine is necessary
 to save the mother's life1 and it is   
not certain to bring on abortion1 though
 it is likely to do so1 then the good   
effect is greater and more immediate or 
direct than the bad effect2 then give   
the medicine to save the mother1 and    
permit the probable death of the child4 

#b4 ,if the medicine is not necessary to
 save the mother's life1 though very    
useful1 for the sake of such an         
advantage1 you cannot justly expose the 
child's life to serious danger4  #c4    
,but if the danger it is exposed to is  
not serious but slight1 and the remedy1 
though not necessary1 is expected to be 
very useful to the mother1 you may then 
administer the medicine2 for a slight   
risk need not prevent a prudent man from
 striving to obtain very good results4  
#d4 ,but what if the drug is necessary  
to save the mother1 and as dangerous to 
the child as it is beneficial to her2   
can you then give the medicine with the 
moral certainty that it will save her   
and kill her child8 ,when we know       
principles clearly we can apply them    
boldly4 ,i answer then with this        
important distinction3 you can give such
 medicine as will act on her system1 her
 organs1 in a manner to save her life1  
and you may permit the sad effects which
 will indirectly affect the child2 but  

you cannot injure the child directly as 
a means to benefit her indirectly2 that 
would be using a bad means to obtain a  
good end4  ,suppose1 then1 what is said 
to be a real case of occasional         
recurrence in obstetrical practice1     
namely1 that a pregnant mother is seized
 with violent and unceasing attacks of  
vomiting1 so that she must die if the   
vomiting be not stopped2 and you1 as    
well as the consulting physician called 
in1 can discover no means of relieving  
the vomiting except by procuring an     
abortion1 by relieving the womb of its  
living burden4 ,abortion is then the    
means used to stop the vomiting4 ,are   
you justified in using that means8      
,abortion is the dislodging of the child
 from the only place where it can live  
and where nature has placed it for that 
purpose4 ,therefore abortion directly   
kills the child1 as truly as plunging a 
man under water kills the man4 ,can you 
thus kill the child to save the mother8 
,you cannot4 ,neither in this case nor  

in any other case can you do evil that  
good may come of it4  ,you notice1      
gentlemen1 that ,i lay great stress on1 
this principle that the end can never   
justify the means4 ,it is an evident    
principle1 which all civilized nations  
acknowledge4 ,its opposite1 that the end
 justifies the means1 is so odious that 
the practice of it is a black stamp of  
ignominy on any man or any set of men   
that would be guilty of it4 ,the        
,catholic ,church has1 all through her  
course of existence1 taught the maxim   
that the end cannot justify the means4  
,she has impressed it on the laws and   
hearts of all ,christian peoples4 ,she  
inculcates it in the teachings of all   
her theologians and moral philosophers  
and in all her channels of education4   
,and since we ,jesuits are among her    
leading educators and writers1 we have  
maintained that thesis in thousands of  
printed volumes1 as firmly as ,i am     
maintaining it before you to-day4 ,no   
,jesuit ever1 nor any ,catholic         

theologian or philosopher1 has taught   
the contrary4 ,and yet even such        
pretentious works as the ,encyclopdia   
,britannica have carried all over the   
earth the slander that we teach the     
opposite maxim1 that the end does       
justify the means1 and the odious term  
,jesuitry has been coined to embody that
 slander4  ,is it not strange then1 very
 strange1 that they who thus falsely    
accuse us are often the very men who    
will procure an abortion to save the    
mother's life1 who will do wrong that   
good may come of it8 ,and you find such 
men maintaining the lawfulness of       
abortion on the plea that the operation1
 whether licit or not1 is a necessary   
means to obtain a good end4  ,,iv4      
,gentlemen1 if once you grant that grave
 reasons would justify abortion1 there  
is no telling where you will stop in    
your career of crime4 ,to-day1 for      
instance1 you are called to attend a    
mother1 who1 you think1 must die if you 
do not bring on a miscarriage4 ,you are 

urged to do it by herself and her       
husband1 and perhaps by other           
physicians4 ,there are money            
considerations too1 and the possible    
loss of practice4 ,will you yield to the
 temptation8 ,the next day you are      
visited by a most respectable lady2 but 
she has been unfaithful to her marriage 
vow4 ,the consequences of her fall are  
becoming evident4 ,if her husband finds 
out her condition1 he may wreak a       
terrible vengeance4 ,her situation is   
sadder than that of the sick mother of  
the preceding day4 ,you can easily      
remove the proof of her guilt1 we will  
suppose1 and spare a world of woes4     
,will you withstand the temptation8 ,the
 third day comes a young lady1 a        
daughter of an excellent family2 bright 
prospects lie before her2 her parents'  
lives and happiness are wrapped up in   
that girl4 ,but in an evil hour she has 
been led astray4 ,now she is with child4
 ,she begs1 she implores you to save her
 from ruin1 and her parents from        

despair4 ,if you do not help her1 some  
other ,doctor or a quack will do it2 but
 you could do it so much better4 ,if you
 should have yielded on the two former  
occasions1 if you have already stained  
your heart with innocent blood1 will you
 now refuse8 ,where are you going to    
draw the line8  ,the passions of men are
 insatiate1 even in modern society2 the 
more you yield to them1 the stronger    
grows their craving4 ,let me illustrate 
my meaning by a fact that happened a few
 years ago in ,russia4 ,it is just to   
our point4 ,during a severe winter1 a   
farmer1 having his wife and children    
with him on a wagon1 was driving through
 a wild forest4 ,all was still as death 
except the howling of wolves in the     
distance4 ,the howling came nearer and  
nearer4 ,after a while a pack of hungry 
wolves was seen following in the track  
of the wagon4 ,the farmer drove on      
faster1 but they gained on him4 ,it was 
a desperate race to keep out of their   
reach4 ,at last they are just back of   

the wagon4 ,what can be done8 ,the next 
moment the wolves may jump on the       
uncovered vehicle4 ,the children1       
horrified1 crouch near their trembling  
mother4 ,suddenly the father1 driven to 
despair1 seizes one of the little       
children and flings it among the pack of
 wolves1 hoping that by yielding them   
one he may save the rest4 ,the hungry   
beasts stop a few moments to fight over 
their prey4 ,but soon they are in hot   
pursuit again1 fiercer because they have
 tasted blood4 ,a second child is thrown
 to them1 and after a while a third and 
a fourth4  ,human society1 gentlemen1 in
 this matter of sacrificing ftal life is
 as insatiable as a pack of hungry      
wolves4 ,woe to any one of you if he    
begins to yield to its cravings2 there  
is no telling where he will stop4 ,in   
proof of my statement1 let me read to   
you an extract from a lecture on        
,obstetrics1 delivered by ,doctor       
,hodge1 of ,philadelphia1 to the medical
 students of the ,university of         

,pennsylvania3 ,we blush while we record
 the fact1 that1 in this country1 in our
 cities and towns1 in this city where   
literature1 science1 morality1 and      
,christianity are supposed to have so   
much influence2 where all the domestic  
and social virtues are reported as being
 in full and delightful exercise2 even  
here individuals1 male and female1 exist
 who are continually imbruing their     
hands and consciences in the blood of   
unborn infants2 yea1 even medical men   
are to be found who1 for some trifling  
pecuniary recompense1 will poison the   
fountains of life1 or forcibly induce   
labor1 to the certain destruction of the
 ftus and not infrequently of the       
parent4  ,so low1 gentlemen1 is the     
moral sense of the community on this    
subject1 so ignorant are the greater    
number of individuals1 that even        
mothers1 in many instances1 shrink not  
from the commission of this crime1 but  
will voluntarily destroy their own      
progeny1 in violation of every natural  

sentiment and in opposition to the laws 
of ,god and man4 ,perhaps there are few 
individuals in extensive practice who   
have not had frequent applications made 
to them by the fathers and mothers of   
unborn infants 7respectable and polite  
in their general appearance and manners7
 to destroy the fruit of illicit        
pleasure1 under the vain hope of        
preserving their reputation by this     
unnatural and guilty sacrifice4         
,married women1 also1 from the fear of  
labor1 from indisposition to have the   
care1 the expense1 or the trouble of    
children1 or some other motive equally  
trifling and degrading1 have solicited  
that the embryo should be destroyed by  
their medical attendant4 ,and when such 
individuals are informed of the nature  
of the transaction1 there is an         
expression of real or pretended surprise
 that any one should deem that act      
improper1 much more guilty2 nay1 in     
spite even of the solemn warnings of the
 physician1 they will resort to the     

debased and murderous charlatan1 who1   
for a piece of silver1 will annihilate  
the life of the ftus1 and endanger even 
that of its ignorant or guilty mother4  
,this low estimate of the importance of 
ftal life is by no means restricted to  
the ignorant or to the lower classes of 
society4 ,educated1 refined1 and        
fashionable women1 yea1 in many         
instances1 women whose lives are in     
other respects without reproach--mothers
 who are devoted with an ardent and     
self-denying affection to the children  
who already constitute the family--are  
perfectly indifferent concerning the    
ftus in utero4 ,they seem not to realize
 that the being within them is indeed   
animate1 that it is in verity a human   
being1 body and spirit2 that it is of   
importance2 that its value is           
inestimable1 having reference to this   
world and the next4 ,hence they in every
 way neglect its interests4 ,they eat   
and drink1 they walk and ride2 they will
 practise no self-restraint1 but will   

indulge every caprice1 every passion1   
utterly regardless of the unseen1       
unloved embryo4444  ,these facts are    
horrible1 but they are too frequent and 
too true2 often1 very often1 must all   
the eloquence and all the authority of  
the practitioner be employed2 often he  
must as it were grasp the conscience of 
his weak and erring patient1 and let her
 know1 in language not to be            
misunderstood1 that she is responsible  
to her ,creator for the life of the     
being within her4 7,wharton and ,still's
 ,med4 ,jur41 ,parturition1 p4 #ib47    
,dr4 ,walter ,channing1 of              
,massachusetts1 refers to the difficulty
 of obtaining a conviction for abortion1
 and adds3 ,i believe there has never   
been one in this ,state1 this moral     
,state by eminence1 and perhaps in none 
is this crime more rife4 7,boston ,med4 
and ,surg4 ,journal1 ,april1 #ahei1 p4  
#ace74  ,v4 ,we have1 then1 proved1     
gentlemen1 two important and pregnant   
principles3 #a4 ,that we can never      

directly procure abortion1 and #b1 that 
we can procure it indirectly in extreme 
cases2 or rather that we can take such  
extreme measures in pressing danger as  
may likely result in abortion against   
our will4  ,while these principles are  
clear and undoubted1 there are cases in 
which the right application of them is  
beset with great difficulties4 ,these   
often occur in connection with what is  
called ectopic or extra-uterine         
gestation1 namely1 when the nascent     
human form lodges in some recess not    
intended by nature for its abode4 ,of   
late years1 ,dr4 ,velpeau1 of ,paris2   
,dr4 ,tait1 of ,birmingham1 and many    
other eminent physicians have shown that
 cases of ectopic gestation are more    
numerous than had been supposed2 one    
practitioner reports that he had        
attended fifty cases1 another           
eighty-five4  #a4 ,we will first suppose
 the case of an interior growth         
occurring1 the nature of which cannot be
 determined4 ,it may be only a tumor1   

yet it may be the growth of a living    
ftus4 ,if no immediate crisis is feared1
 you will wait1 of course1 for further  
developments4 ,if it proves to be a     
child1 you will attempt no operation    
till it becomes viable at least4 ,but   
suppose that fatal consequences are     
apprehended before the presence of a    
human being can be ascertained by the   
beating of the heart2 suppose that delay
 would endanger the mother's life2 and  
yet if you undertake to cut out the     
tumor1 you may find it to contain ftal  
life4 ,in such urgent danger1 can you   
lawfully perform the operation8 ,let us 
apply our principles4 ,you mean to      
operate on a tumor affecting one of the 
mother's organs4 ,the consequences this 
may have for the child are not directly 
willed1 but permitted4 ,the four        
conditions mentioned before are hereby  
verified1 under which the evil result1  
the death of the possible ftus1 may be  
lawfully permitted2 namely3 7a7 ,you do 
not wish its death2 7b7 ,what you intend

 directly1 the operation on the mother's
 organism1 is good in itself2 7c7 ,the  
good effect intended1 her safety1 to    
which she has an undoubted right1       
overbalances the evil effect1 the       
possible death of the child1 whose right
 to life is doubtful1 since its very    
existence is doubtful2 now1 a certain   
right must take precedence of a doubtful
 right of the same species2 7d7 ,the    
evil is not made the means to obtain the
 good effect 7see ,am4 ,eccl4 ,rev41    
,nov41 #ahic1 p4 #cec74 ,this last      
condition would not be verified if it   
were proposed1 not to cut out the cyst1 
but to destroy its contents by an       
electric current4 ,then1 it would seem1 
the ftus itself1 if there be one1 would 
be directly attacked4  #b4 ,the case    
would present greater difficulties if   
the growth in question were known to    
contain a living ftus4 ,such a case is  
discussed in all its details1 with      
remarkable philosophical acumen1 and in 
the light of copious information        

furnished by prominent members of the   
medical profession1 in the pages of the 
,american ,ecclesiastical ,review for   
,november1 #ahic1 pages #cca-cfj4 ,the  
participants in this interesting        
discussion are writers who enjoy a      
world-wide reputation for keenness of   
intellect and soundness of doctrine in  
philosophical and theological learning4 
,they are not at all agreed as to the   
practical conclusion arrived at1 and    
even those who agree to the same        
conclusion do so for different reasons4 
,three of them agree that in the case of
 a cyst known to contain a living       
embryo1 when a rupture most probably    
fatal to mother and child is imminent1  
the abdominal section might be performed
 lawfully1 the cyst opened and the child
 baptized before its certain death4 ,two
 of these justify this conclusion on the
 principle that the death of the child  
is then permitted only or indirectly    
intended2 one maintains that the killing
 of the embryo is then directly         

procured1 but he considers that an      
embryo in a place not intended for it by
 nature is where it has no right to be1 
and therefore may be treated as an      
unjust aggressor upon the mother's life4
 ,at least one of the disputants        
condemns the operation as absolutely    
unlawful4  ,gentlemen1 when such        
authorities disagree1 ,i would not      
presume to attempt a theoretic decision4
 ,but then we have this other principle 
practically to guide us1 that in matters
 so very doubtful we need not condemn   
those who differ from our view1 as long 
as they feel convinced that they are    
acting wisely and prudently4 ,in        
,jurisprudence1 reason must be our guide
 when it affords us evidence of the     
truth4 ,but when our reason offers      
arguments on both sides of the question1
 so that we can arrive at no certain    
conclusion1 then we act prudently by    
invoking the authority of wiser minds   
who make moral questions a speciality1  
and we are perfectly safe if we follow  

the best authority obtainable4  ,a      
,catholic physician has here a special  
advantage3 for he has in cases of great 
difficulty the decisions of ,roman      
tribunals1 composed of most learned men1
 and renowned for the thoroughness of   
their investigations and the prudence of
 their verdicts1 to serve him as guides 
and vouchers for his conduct4 ,although 
these tribunals claim no infallibility1 
yet they offer all the advantages that  
we look for1 with regard to civil       
matters1 in the decisions of our        
,supreme ,court4 ,these ,roman courts   
have uniformly decided against any      
operation tending directly to the death 
of an innocent child 7,am4 ,eccl4 ,rev41
 ,nov41 #ahic1 pp4 #ceb1 #cec2 ,feb41   
#ahie1 p4 #aga74  ,non-,catholics are1  
of course1 not obliged to obey such     
pronouncements2 yet1 even for them1 it  
cannot be injurious1 but rather very    
useful1 to know the views of so         
competent a court on matters of the most
 vital interest in their learned        

profession4 ,this is the reason why the 
,medical ,record has published of late  
so many articles on the teachings of    
,catholic authorities with regard to    
craniotomy and abortion 7see vol4 xlvii4
 nos4 #e1 #i1 #be2 vol4 xlviii4 nos4 #a1
 #b1 #c1 #d74     ,,lecture ,,iv4       
,,views ,,of ,,scientists ,,and         
,,sciolists4   ,in my former lectures1  
gentlemen1 ,i explained to you the      
principles condemnatory of craniotomy   
and abortion1 viewing these chiefly from
 the standpoint of the ethical          
philosopher and the jurist4 ,not being a
 physician myself1 ,i think it proper1  
on matters of so much importance1 to    
quote here freely from a lecture        
delivered on this subject by a late     
professional gynecologist1 an old       
experienced practitioner1 who was for   
many years a professor of obstetrics in 
the ,st4 ,louis ,medical ,college4 ,i   
quote him with the more pleasure because
 of my personal acquaintance with him1  
and of the universal esteem for ability 

and integrity in which he was held by   
the medical profession4  ,dr4 ,l4       
,charles ,boislinire1 to whom ,i refer1 
had by his scientific acquirements and  
his successful practice1 during forty   
years of his life1 become1 to a great   
extent1 identified with the progress of 
the science of obstetrics in this       
country2 and a few months before his    
late demise1 he had published a useful  
work on ,obstetric ,accidents1          
,emergencies1 and ,operations4  ,in     
#ahib he read1 before the ,st4 ,louis   
,obstetrical and ,gynecological         
,society1 a lecture on the moral aspects
 of craniotomy and abortion1 of which a 
considerable portion is very much to our
 present purpose4 ,the ,doctor herein   
clearly demonstrates that1 in this      
matter at least1 ,ethics and ,medical   
,science are to-day perfectly           
concordant4 ,he says3  ,the operation of
 craniotomy is a very old one4 ,the     
ancients entertained the belief that1 in
 difficult labors1 the unborn child was 

an unjust aggressor against the mother1 
and must1 therefore1 be sacrificed to   
save her life4  ,hippocrates1 ,celsus1  
,avicenna1 and the ,arabian ,school     
invented a number of vulnerating        
instruments to enter and crush the      
child's cranium4 ,with the advance of   
the obstetric art1 more conservative    
measures were gradually adopted1 such as
 the forceps1 version1 induction of     
premature labor1 and1 finally1 ,cesarean
 section4  ,cesarean section is reported
 to have been performed by ,nicola de   
,falcon in the year #adia4 ,nufer1 in   
#aejj1 and ,rousset1 in #aeha1 performed
 it a great many times1 always          
successfully2 so that1 ,scipio ,murunia 
affirms1 it was as common in ,france    
during that epoch as blood-letting was  
in ,italy1 where at that time patients  
were bled for almost every disease4     
,however1 a reaction soon followed1     
headed by ,guillemau and ,ambrose ,pare1
 who had failed in their attempts at    
,cesarean section4 ,in our days a marked

 change of opinion on this interesting  
and delicate question is rapidly taking 
place4  ,with these advances in view1   
the question now is3  ,are we ever      
justified in killing an unborn child in 
order to save the mother's life8  ,this 
is a burning question1 and the sooner   
and more satisfactorily it is settled1  
the greater will be the peace to the    
medical mind and conscience4  ,in answer
 to the question1 ,i1 at the outset1    
reply ,no1 and claim that1 under no     
conditions or circumstances1 is it ever 
allowable to destroy the life of the    
child in order to increase the mother's 
chances of living4 ,and the day may     
arrive when1 by the law of the land1 the
 act will be considered criminal and    
punished as such4 ,in support of this   
opinion1 and to illustrate this         
position1 allow me to take a purely     
ethical and medico-legal view of the    
subject1 and to relate to you a parallel
 case1 as also the decision arrived at  
by the ,lord ,chief ,justice of         

,england1 ,judge ,coleridge1 than whom  
there is not a greater jurist living4   
,the case is that of the ,british yacht 
',mignonette4' ,on ,july #e1 #ahhd1 the 
prisoners ,dudley and ,stevens1 with one
 ,brookes and the deceased1 an ,english 
boy between #ag and #ah years of age1   
part of the crew of the ',mignonette1'  
were cast away in a storm at sea #a1fjj 
miles from the ,cape of ,good ,hope1 and
 were compelled to take to an open boat4
  ,they had no supply of water1 no      
supply of food1 and subsisted for twenty
 days on two pounds of turnips and a    
small turtle they had caught4 ,they     
managed to collect a little rain-water  
in their oil-skin capes4  ,on the       
eighteenth day1 having been without food
 for seventeen days and without water   
for five days1 the prisoners suggested  
that some one should be sacrificed to   
save the rest4 ,brookes dissented1 and  
the boy1 to whom they referred1 was not 
consulted4 ,on that day ,dudley and     
,stevens spoke of their having families1

 and of their lives being more valuable 
than that of the boy4 ,the boy was lying
 in the bottom of the boat1 quite       
helpless1 extremely weak and unable to  
make any resistance2 nor did he assent  
to be killed to save the others4        
,dudley1 with the assent of ,stevens1   
went to the boy and1 telling him that   
his time had come1 put a knife into his 
throat and killed him4 ,they fed upon   
his flesh for four days4 ,on the fourth 
day the boat was picked up by a passing 
vessel1 and the sailors were rescued1   
still alive but in a state of extreme   
prostration4  ,the prisoners were       
carried to the port of ,falmouth and    
committed for trial1 the charge being   
murder4 ,their excuse was that1 if they 
had not killed the boy and fed upon his 
flesh1 there being no sail in sight1    
they would have died of starvation      
before being rescued4 ,they said that   
there was no chance of saving their     
lives1 except by killing some one for   
the others to eat4 ,the prisoners were  

committed for murder and sentenced to   
death1 but appealed to the mercy of the 
court1 pleading ignorance4 ,it was found
 by the verdict that the boy was        
incapable of resistance1 and authorities
 were then quoted to prove that1 in     
order to save your own life1 you have   
the right to take the life of an unjust 
aggressor in self-defence--a principle  
the truth of which is universally       
admitted4  ,but the evidence clearly    
showed that the defenceless boy was not 
an unjust aggressor against their lives1
 and1 consequently1 their only plea was 
that of expediency4  ,in a chapter in   
which he deals with the exception       
created by necessity1 ,lord ,hale1      
quoted by ,justice ,coleridge1 thus     
expresses himself3  ',if a man be       
desperately assaulted and in peril of   
death1 and cannot otherwise escape1     
except by killing an innocent person    
then present1 the act will not acquit   
him of the crime and punishment of      
murder2 for he ought rather to die      

himself than to kill an innocent4'  ,in 
the case of two men on a plank at sea1  
which can only support one1 the right of
 one occupant to throw the other        
overboard to save his own life1 and in  
the instance of sailors1 to save        
themselves1 throwing passengers in the  
sea1 are equally condemned by ,lord     
,coleridge as unjustifiable homicide4   
,so that under no circumstances is it   
allowable to kill an innocent aggressor 
to save your own life4 ,i say innocent  
aggressor2 but it is allowed1 in        
self-defence1 to kill1 if necessary1 an 
unjust aggressor against your life4     
,this case is exactly analogous to that 
of the child lying helpless in its      
mother's womb4 ,she causes its death by 
her consent to the act of her agent1 the
 physician in attendance4  ,remark that 
,brookes1 one of the sailors1 dissented 
to the killing of the sailor-boy4 ,this 
may happen in consultation1 when one of 
the consultants does not admit the right
 to kill an unborn child4 ,please also  

remember that the sailor-boy lay        
helpless at the bottom of the boat when 
his assailants killed him to save their 
own lives4  ,the child is not an unjust 
aggressor against the mother4 ,it is    
placed in the womb without its consent  
and is defenceless4 ,it is the mother   
who is1 as it were1 the aggressor from  
the obstacles caused by a deformed      
pelvis1 tumors1 etc42 and she has not   
the right to ask or consent to the      
killing of the child who does not attack
 her4  ,therefore1 ,i repeat that the   
two cases are analogous2 and if1 as     
remarked by ,justice ,coleridge1 murder 
was committed in the first instance1 so 
is murder committed in the analogue4    
,so1 we see1 the principal points of the
 opinion enunciated by the learned      
judge1 and the principles therein laid  
down1 can1 with equal force1 be applied 
to the non-justification of craniotomy1 
by which the life of a defenceless child
 is sacrificed to save the mother4      
,notice also that two of the            

perpetrators of the deed claimed that   
they had families1 and that their lives 
were more valuable than that of the     
murdered boy4 ,by craniotomists this    
reason or excuse is frequently given    
with much sentimentality to justify the 
killing of the child4 ,the child1 they  
say1 has no social value1 the mother is 
the idol of her husband1 the pride of   
the household1 often an ornament to     
society1 the mother of living or        
possible children4 ,therefore1 her life 
is more valuable than that of the unborn
 child4 ,but who is to be the judge of  
the value of life8 ,were not ,scipio    
,africanus1 ,manlius1 was not ,csar1    
from whom the very name of the          
operation1 delivered by section from    
their mother's womb8 ,the operation was 
familiarly known to ,shakespeare1 who   
tells us3      ',macduff was from his   
mother's womb untimely ripped4'  ,there 
can never be a necessity for            
killing--except an unjust aggressor and 
in self-defence--unless the killing can 

be justified by some recognized excuse  
admitted by the law4 ,in the case of the
 murdered sailor-boy1 there was not such
 an excuse1 unless the killing was      
justified by what has been called       
necessity4 ,but1 as stated above1 there 
never is an excuse for killing an       
innocent aggressor1 and the temptation  
to the act and its expediency is not    
what the law has ever called necessity4 
,nor is this to be regretted2 for if in 
this case the temptation to murder and  
the expediency of the deed had been held
 by law as absolute defence of the deed1
 there would have been no guilt in the  
case4 ,happily this is not so4 ,the plea
 of necessity once admitted might be    
made the legal cloak for unbridled      
passions and atrocious crimes1 such as  
the producing of abortion1 etc4  ,as in 
the case of this young sailor1 so in the
 killing of an unborn child1 no such    
excuse can be pleaded2 the unborn child 
cannot be the aggressor1 no more so than
 the defenceless sailor-boy was4  ,to   

preserve one's life is1 generally       
speaking1 a duty3 but it may be the     
plainest duty1 the highest duty1 to     
sacrifice one's life4 ,war is full of   
such instances in which it is not man's 
duty to live1 but to die4 ,the ,greek   
and ,latin authors contain many examples
 in which the duty of dying for others  
is laid down in most glowing and        
eloquent language4  ',dulce et decorum  
est pro patria mori1' says ,horace4     
,such was heathen ethics1 and it is     
enough in a ,christian country to teach 
that there is not always an absolute and
 unqualified necessity to preserve one's
 life4  ,thus1 as a parallel case1 is   
the situation of a woman in a difficult 
labor1 when her life and that of her    
unborn child are in extreme danger4 ,in 
this instance1 it is the mother's duty  
to die rather than to consent to the    
killing of her child4  ,in a subject of 
such delicacy and importance ,i have    
avoided all argument based upon the     
doctrines of any particular religion1   

and considered the subject upon its     
purely ethical and scientific basis4 ,i 
am aware that ,i am taking a position   
quite at variance with that occupied by 
many men influenced by former teachings 
and prejudices4  ,i respect the honest  
convictions of those opposed to the     
opinions presented in this paper4 ,but  
it is hoped that thoughtful physicians  
will soon reconsider their views and    
adopt a more just and humane method of  
dealing with the rights of a living     
unborn child4  ,as a hopeful sign1 it is
 to be noticed that a gradual change is 
taking place in the opinions of the     
profession as to the propriety of       
performing craniotomy4 ,busey says3 ',to
 state the issue plainly1 the averment  
must be made that no conscientious      
physician would deliberately and        
wilfully kill a ftus1 if he believed    
that the act was a violation of the     
commandment ,thou shalt not kill4' ,it  
has been well said by ,barnes1 the      
ablest and most conservative defender of

 craniotomy1 that 'it is not simply a   
question for medicine to decide4        
,religion and the civil law claim a     
preponderating voice4 ,in the whole     
range of the practice of medicine1 there
 arises no situation of equal           
solemnity4'  ,having thus far considered
 the subject from a purely ethical      
standpoint1 ,i shall now present its    
scientific and practical aspect4        
,parvin says that the improved ,cesarean
 section has given in ,germany results  
so satisfactory that1 possibly1 the day 
is at hand when craniotomy upon the     
living ftus will be very rarely         
performed1 if done at all4 ,kinkead1 a  
high ,english authority1 states3 ',to   
reduce the bulk of the child1 or to     
extract it afterward through a pelvis of
 two and one-half or less conjugate     
diameter1 is an operation of extreme    
difficulty1 lengthy1 requiring a very   
great experience1 as far as the mother  
is concerned1 requiring an amount of    
manual dexterity rarely to be acquired  

outside of a large city4 ,while1 on the 
other hand1 the ,cesarean section is an 
easy operation1 capable of successful   
performance by any surgeon of ordinary  
skill4'  ,tait remarks that he 'feels   
certain that the decision of the        
profession will be1 before long1 to give
 up the performance of such operations  
as are destructive to the child1 in     
favor of an operation that saves it1 and
 subjects the mother to little more     
risk4 ,the operation of ,cesarean       
section1 or the ,porro amputation of the
 pregnant womb1 will revolutionize the  
obstetric art1 and in two years we shall
 hear no more of craniotomy2 for the    
improved method will save more lives1   
and is far easier of performance4 ,it is
 the easiest operation in abdominal     
surgery1 and every country practitioner 
ought to be able1 and always prepared1  
to do it4' ,so said ,lawson ,tait in    
#ahhh4  ,i could quote many other       
authorities1 showing the change that is 
taking place in the profession upon this

 important question4 ,it is established 
by the consensus of professional opinion
 that craniotomy has been frequently    
performed in cases where delivery could 
have been safely accomplished by the    
forceps1 turning1 and even by the       
unaided power of nature 7,busey72 and   
there is no case known to him where a   
woman1 on whom a section had been       
successfully performed1 has refused to  
submit to its repetition in subsequent  
pregnancies4 ,in ,belgium the ,cesarean 
section has been performed seven times  
on the same woman1 and in ,philadelphia 
three times4 ,doctor ,bretoneaux1 of    
,tours1 has performed it six times on   
the same woman2 and this woman his wife4
 ',the brutal epoch of craniotomy has   
certainly passed4 ,the legitimate       
aspiration and tendency of science is to
 eliminate craniotomy on the living and 
viable child from obstetric             
practice4'--,barnes' words as quoted by 
,busey4 ,tyler ,smith is in perfect     
accordance with ,barnes4 ,barnes again  

writes3 ',for the ,cesarean section two 
very powerful arguments may be advanced4
 ,first1 that the child is not          
sacrificed4 ,second1 that the mother has
 a reasonable prospect of being saved4' 
,late reports of the ,dublin ,rotunda   
,hospital show that1 in #c1fca cases of 
labor1 craniotomy was performed only    
four times1 and in three of these1      
positive diagnosis of the child's death 
was ascertained before the operation4   
,in one of these cases the diagnosis was
 doubtful4  ,more ,madden1 a celebrated 
obstetrician of forty years' experience1
 never performed it once4  ',the        
brilliant achievements in abdominal     
surgery give assurance that the         
,cesarean section is not only a         
legitimate operation1 but one almost    
free from danger2 also1 that the tragic 
scenes heretofore witnessed in certain  
cases1 in which the destruction of the  
child was resorted to1 may be relegated 
to history 7,a4 ,p4 ,clarke74'  ,further
 on1 ,dr4 ,boislinire speaks more       

directly of abortion4 ,he says3  ,the   
principle once admitted that you are not
 justifiable in killing an innocent     
aggressor except in self-defence1       
equally prohibits any interference with 
early gestation4  ,from the moment of   
conception the child is living4 ,it     
grows1 and what grows has life4 ',homo  
est qui homo futurus1' says an ancient  
and high authority4  ,therefore1 fticide
 is not permissible at any stage of     
utero-gestation4  ,the killing of the   
defenceless ftus is sometimes done in   
cases of uncontrollable vomiting of     
pregnancy1 in cases of tubal or         
abdominal gestation1 and the killing of 
the ftus is done by electricity1        
injections of morphine in the amniotic  
sac1 the puncturing of that sac1 etc4   
,this practice is too lightly adopted by
 thoughtless or conscienceless          
physicians4 ,this practice is much on   
the increase4 ,i once heard a known     
obstetrician of the old school say3 ',i 
would as lief kill1 if necessary1 an    

unborn child as a rat4' ,so much for the
 estimate he put on the value of human  
life6 ,o tempora6 ,o mores6  ,is it not 
time that this wanton 'massacre of the  
innocents' should cease8  ,without      
wishing to load this paper with         
elaborate statistics1 ,i shall furnish  
the latest arrived at in the two        
operations of craniotomy and ,cesarean  
section4  ,in the combined reports of   
the clinics of ,berlin1 ,halle1 and     
,dresden1 the maternal mortality in     
craniotomy was #e4h per cent--of course1
 one hundred per cent of the children   
lost4  ,in ,cesarean section the        
maternal mortality was eight or eleven  
per cent2 children's mortality1 thirteen
 per cent4  ,caruso1 the latest and most
 reliable statistician1 not an optimist1
 sums up the results from the different 
clinics1 and comes to the conclusion    
that craniotomy shows ninety-three and  
one one-hundredth mothers recover1      
,cesarean section eighty-nine and four  
one-hundredths4  ,caruso1 therefore1    

concludes that craniotomy on the living 
child is to be superseded by ,cesarean  
section4 ,he says1 therefore1 that the  
mother has three chances out of four1   
and her child nine out of ten1 for life4
  ,leopold1 as stated above1 shows a    
much better result1 viz43 ninety-five   
mothers saved out of one hundred by     
,cesarean section1 a result equal that  
obtained in craniotomy4  ,you notice1   
gentlemen1 that the eminent physician   
whom ,i have been quoting speaks with   
much indignation of the killing of the  
embryo1 when he calls it a massacre of  
the innocents4 ,by this odious term we  
usually denote the massacre of the babes
 at ,bethlehem1 ordered by the infamous 
,herod to defend himself against the    
future aggression1 as he imagined1 of   
the new-born ,king of the ,jews4 ,a     
craniotomist would1 no doubt1 feel      
insulted at being compared with ,herod4 
,and yet1 if we examine the matter      
closely1 we shall find that the two     
massacres1 ,herod's and the             

craniotomist's1 could only be defended  
by the same plea1 that of necessity4    
,necessity knows no law1 writes ,dr4    
,galloway1 in his defence of craniotomy1
 to which ,i referred in a former       
lecture4 ,the same law1 he writes in the
 ,medical ,record for ,july #bg1 #ahie1 
which lies at the basis of              
,jurisprudence in this respect justifies
 the sacrifice of the life of one person
 when actually necessary for the        
preservation of the life of another1    
when the two are reduced to such        
extremity that one or the other must    
die4 ,this is the necessitas non habet  
legem4  ,did not ,herod look on the     
matter just in that light8 ,expecting   
,christ to be1 not a spiritual1 but a   
temporal ruler1 as the ,jewish nation   
supposed at the time1 he looked upon it 
as a case of necessity to sacrifice the 
lives of the innocents for his own      
preservation4 ,necessity knows no law   
was his principle4 ,true1 many had to   
die on that occasion to save one2 but   

then he was a king4 ,anyhow1 their death
 was necessary1 and necessitas non habet
 legem2 that settles it3 ,herod must not
 be blamed1 on that principle4 ,it is   
not even certain that1 cruel as he was1 
he would have confessed1 with the modern
 obstetrician1 ,i would as lief1 if it  
were necessary1 kill an unborn child as 
a rat4  ,such sentiments1 revolting as  
they are1 and a disgrace to             
civilization1 are the natural outcome of
 rash speculations about the first      
principles of morality4  ,the principle 
,necessitas non habet legem has indeed a
 true and harmless meaning when properly
 understood2 it means that no law is    
violated when a man does what he is     
physically necessitated to do1 and that 
no law can compel him to do more than he
 can do4 ,thus a disabled soldier cannot
 be compelled to march on with his      
regiment2 necessity compels him to      
remain behind4 ,in this sense the       
principle quoted is a truism2 hence its 
universal acceptance4 ,applying the same

 principle in a wider sense1 moralists  
agree that human law-givers do not1 and 
in ordinary circumstances cannot1 impose
 obligations the fulfilment of which    
requires extraordinary virtue4 ,even    
,god ,himself does not usually exact of 
men the performance of positive heroic  
acts4 ,but no such plea can be urged to 
justify acts which ,god forbids by the  
natural law4#a ,when necessity is used  
as a synonym for a very strong reason1  
as it is in the plea of the             
craniotomist1 then it is utterly false  
that very strong reasons for doing an   
act cannot be set aside by a divine law 
to the contrary2 what is wrong in itself
 can never become right1 even though the
 strongest arguments could be adduced in
 its favor4 ,it would be doing wrong    
that good may come of it1 or making the 
end justify the means4 ,such principles 
may be found in the code of tyrants and 
criminals1 but should not be looked for 
in the code of ,medical ,jurisprudence4 
#a ,see this point more fully treated in

 the ,author's ,moral   ,philosophy1    
,book4 ,i4 c4 ii41 ,the ,morality of    
,human ,acts4  ,there is but one plea   
left1 ,i believe1 on which1 of late     
years1 it is sometimes attempted to     
justify the murder of little children4  
,it is the plea of some evolutionists   
who maintain that the infant has not yet
 a true human soul4 ,i should not deign 
to consider this theory if it were not  
that ,i find it seriously treated by a  
contributor to the ,medical ,record1 in 
an article which1 on ,september #d1     
#ahie1 concluded a long discussion on   
craniotomy published in that learned    
periodical4  ,the writer of this article
 asserts3 ,procuring the death of the   
ftus to save the life of the mother is1 
,i am sure1 to be defended on ethical   
grounds4 ,and here is the way he        
attempts to defend it3 ,we may safely   
assume1 he argues1 that the theory of   
evolution is the best working hypothesis
 in every branch of natural science4 ,we
 are learning through ,herbert ,spencer 

and all late writers on ethics and      
politics1 that the same principle will  
best explain the facts 7p4 #cie74  ,i do
 not deny that a certain school of      
scientists is trying to rewrite all     
history and all ,ethics and             
,jurisprudence4 ,but the writer         
strangely misstates the case when he    
says that all great writers on ethics   
and politics agree with ,mr4 ,spencer4  
,besides a multitude of others1 ,lord   
,salisbury for one1 has clearly shown of
 late that the school of agnostic       
evolutionists is coming to grief2 it has
 had its short day1 and it is now       
setting below the horizon of ignominy   
and subsequent oblivion4 ,the writer of 
the article in question does not attempt
 to prove the evolution theory2         
therefore ,i need not stop to disprove  
it4 ,but he makes the following         
application of it to our subject--an    
application so shocking to humanity and 
so revolting to common sense that1 if it
 is logical1 it is by itself sufficient 

to refute the whole theory of ,mr4      
,spencer and his school4  ,he argues    
that1 if that theory be admitted1 it    
must necessarily follow that1 while the 
human embryo is from the first alive1 it
 is not a human being until it has      
developed and differentiated to such a  
point as corresponds to that point at   
the birth of the race where the animal  
becomes a man4 ,i am sure1 he adds1 ,i  
do not know when that occurred in the   
past1 and ,i do not know at what point  
it occurs in the individual4444 ,in     
inquiring for that distinct feature     
which distinguishes the man from the    
animal1 ,i find none but mentality4 ,if 
we wait for distinct mentality to appear
 in the development of the individual1  
it would be some time after birth4      
,according to this reasoning a child is 
not known to be a human being till some 
time after its birth4 ,and this is not  
uttered by some speculative philosopher 
in his closet1 but by a medical         
practitioner on his daily rounds1 tools 

in hand1 as it were1 to carry out his   
theory and break the skulls of any and  
all luckless babes that may come in his 
way in the exercise of what he calls his
 legitimate practice4 ,how long after   
birth the child remains without becoming
 a human being1 he does not pretend to  
know2 they remain non-human till they   
manifest mental action4 ,till then1 not 
being human1 he assigns them no human   
rights--no rights at all which we are   
conscientiously obliged to respect4     
,herod may have been right after all    
when he appointed the term of two years 
old and under as the limit of the       
butchery at ,bethlehem4 ,the writer     
pretends to lessen the horror inspired  
by his theory by referring to some      
restrictions of canon law4 ,but what do 
he and his like care about canon law8   
,he would be the first to scout the idea
 of letting canon law limit his freedom 
of action and speculation4  ,what would 
be the real results in practical life if
 we were to accept as rules of conduct  

these rash theories of agnostic         
philosophers and infidel scientists8    
,justly does the writer proceed to say3 
,i am well aware that the idea arouses  
antagonism and inflammatory denunciation
 in some minds4 ,certainly it does4 ,he 
adds3 ,that it the idea will prove to be
 the true one1 however1 depends only on 
the truth of the general theory of      
development4 ,if this be the logical    
consequence of evolution1 or ,darwinism1
 as he calls it1 then all the worse for 
,darwinism4 ,society cannot get along on
 a theory that begets such principles of
 action2 the more so since1 in          
,spencer's and in ,darwin's system1 the 
human soul1 even in grown persons1 is   
only a material modification of the body
 and perishes with it in death4 ,hence  
there would be no responsibility after  
death4 ,on this theory the physician is 
only a lump of very curiously evolved   
matter2 he1 too1 like the embryo1 is    
without an immortal soul1 is not a free 
being1 and therefore is incapable of    

having rights or duties4  ,before we    
remodel our codes of ,ethics and        
,jurisprudence by the admission into    
them of such destructive and            
revolutionary principles1 we shall at   
least be allowed to challenge these     
aggressors and ask solid proof of their 
rash innovations4 ,we may address to    
them the wise words uttered against     
similar speculators by one of the most  
logical of modern reasoners1 the        
illustrious ,cardinal ,newman4 ,why may 
not my first principles contest the     
prize with yours8 they have been longer 
in the world1 they have lasted longer1  
they have done harder work1 they have   
seen rougher service4 ,you sit in your  
easy-chairs1 you dogmatize in your      
lecture-rooms1 you wield your pens3 it  
all looks well on paper2 you write      
exceedingly well2 there never was an age
 in which there was better writing1     
logical1 nervous1 eloquent1 and         
pure1--go and carry it out in the world4
 ,take your first principles1 of which  

you are so proud1 into the crowded      
streets of our cities1 into the         
formidable classes which make up the    
bulk of our population3 try to work     
society by them4 ,you think you can2 ,i 
say you cannot2 at least you have not as
 yet1 it is to be seen if you can4444   
,my principles1 which ,i believe to be  
eternal1 have at least lasted eighteen  
hundred years2 let yours last as many   
months4444 ,these principles have been  
the life of nations2 they have shown    
they could be carried out2 let any      
single nation carry out yours 7,present 
,position of ,catholics in ,england4 p4 
#bic74  ,gentlemen1 let no one trifle   
with the principles of ,ethics and      
,jurisprudence2 human society cannot get
 along without them4 ,morality is the   
heart of civilization3 its principles   
are the life-blood1 which it sends forth
 to feed and warm and strengthen and    
beautify all the organs of its earthly  
frame4 ,a flesh-wound may be healed1 a  
bone may be set1 it may knit and grow   

vigorous again2 but you must not        
puncture the heart1 nor attempt to      
change the natural channels of the      
circulating blood1 under the penalty of 
having a corpse on your hands4 ,so you  
must respect the eternal laws that      
direct the current of man's moral       
actions1 the principles of ,ethics and  
,jurisprudence4     ,,lecture ,v4       
,,venereal ,,excesses4   ,in the opening
 lecture of this course1 ,i remarked to 
you1 gentlemen1 that the scope of       
,medical ,jurisprudence is much wider   
than that of ,medical ,law4 ,it embraces
 many subjects of which human laws take 
no cognizance1 and in particular such   
vicious actions as do not violate the   
rights of others1 but are injurious to  
those only who practise them4 ,they     
undermine the health and shorten the    
lives of the guilty parties1 and bring  
in their train diseases the most        
destructive and often the most          
incurable4 ,it is the physician's       
beneficent task to lessen the weaknesses

 and sufferings of the body1 and to     
prolong human life in well-preserved    
vigor to a green old age4 ,it is not the
 least important part of his valuable   
services to provide for the sound and   
vigorous propagation of the human race  
to future generations4 ,of this         
propagation of our race1 of the laws    
which govern it1 and of the criminal    
abuses by which these laws are violated1
 ,i am to treat in this present lecture4
 ,my subject is ,venereal ,excesses4    
,i4 ,if a physician's purpose were only 
to make money1 his task would then be to
 multiply diseases and infirmities2 he  
would then be as great a curse to       
mankind as he is really intended to be a
 blessing2 and an immense blessing he   
will be to his fellow-men if he studies 
to remove even the remote causes of     
diseases and untimely deaths4 ,he can do
 so in a variety of ways and not the    
least by providing against sexual       
excesses and abuses4 ,these are a       
copious fountain of ill to humanity4 ,a 

host of diseases1 such as tuberculosis1 
diabetes1 cardial and nervous           
affections1 epilepsy1 hysteria1 general 
debility1 weaknesses of sight1 languor  
and general worthlessness1 hypochondria1
 weakness and total loss of reason1 and1
 in married life1 impotence and         
sterility are some of the effects of    
venereal excesses4 ,any excitement of   
the sexual passion before the body has  
received its full development is more or
 less injurious to its welfare2 and all 
excesses or unnatural indulgence of it  
at any period of life is pregnant with  
deplorable consequences4 ,now1 such evil
 practices are too much overlooked by   
many physicians2 yet it is certain that 
thousands of patients might1 by timely  
warning on these matters1 be saved from 
unspeakable mental and physical         
sufferings4 ,to give sensible and       
intelligible directions on a subject as 
delicate as it is important in medical  
practice1 it will be necessary to enter 
into some scientific details4  ,the     

passion which prompts to sexual         
intercourse is altogether natural in    
itself1 and1 as such1 intended by the   
,creator to be indulged in at the right 
time and in the proper manner4 ,it is   
the stimulus which ,he has provided for 
the propagation of the human race4 ,if  
the stimulus is strong at times1 this   
too is a special effect of ,his wisdom2 
because without a powerful prompting of 
this kind1 most men would shirk the     
burden of married life1 just as very    
many would not care to toil if they had 
no hunger and thirst and other bodily   
wants to satisfy4  ,but though all these
 cravings are useful and even           
indispensable to mankind1 all of them   
need the regulation of reason4 ,when    
they are indulged immoderately or in    
unnatural ways1 they become most copious
 sources of bodily diseases1 of mental  
disorders1 and moral degradation4 ,every
 one knows how the passion of drink1    
when abused1 proves the ruination of    
millions2 excessive eating1 too1 injures

 the systems of countless people4 ,but  
no animal passion is more liable to     
become disorderly1 none needs more firm 
control and habitual watchfulness1 than 
the passion of lust4 ,reason dictates   
that it should be indulged for no other 
purpose than that for which the ,creator
 has made it1 namely1 marital           
intercourse4 ,i say marital and not     
merely sexual intercourse2 for outside  
of married life all nations have always 
condemned its indulgence4  ,besides1 it 
is only in the married state that the   
children1 which are the fruit of such   
intercourse1 can be properly educated4  
,to generate a race of young barbarians 
is certainly not the purpose of the     
sexual relations4 ,children must not be 
begotten unless they can be properly    
raised1 in a manner worthy of their     
noble destiny4 ,now1 it is only in the  
married state1 in the family or domestic
 society1 that they can be thus         
educated4 ,they need the tender hand of 
a mother to supply their material wants2

 they need the manly care of a devoted  
father to provide the necessaries of    
life1 his firm hand to break their      
wanton wills1 and his wise direction to 
set them well on the road to temporal   
and eternal happiness4 ,therefore1 no   
one has the right to beget or to bear   
children except in marital life4 ,now1  
the sexual passion is to be exercised   
only in connection with its proper      
object1 the procreation of children and 
the fostering of such mutual love       
between husband and wife as is conducive
 to domestic happiness4 ,therefore this 
passion is to be kept under careful and 
rational constraint4 ,this the law of   
morality requires2 all nations have ever
 exacted that this passion shall be     
subject to established rules2 no        
free-love has ever been tolerated where 
there was the least pretence to         
civilization1 and ,i do not know that it
 was ever permitted even among          
barbarians4  ,even the distant approach 
that ,mormonism made towards free-love  

has been absolutely condemned and       
repressed by the common-sense of the    
,american people1 as incompatible with  
civilization4 ,in fact1 all history     
testifies that the true civilization of 
any race or country rises or falls with 
the restraints imposed on the passion of
 lust2 no polygamous nation has ever    
been more than half-civilized4 ,the     
greatness of ,rome and ,greece decayed  
when the laws of social purity declined2
 and in our own day the immorality of   
what is called the social evil is the   
darkest stain on modern civilization4   
,and what we say of civilization or     
social soundness1 the soundness of the  
body politic1 applies in a great measure
 to individual soundness1 the health of 
every person's mind and body4 ,personal 
purity promotes health and vigor1 it    
lends beauty to form1 gives a keen edge 
to the intellect1 adds energy and brings
 success to manhood1 and prepares for   
enduring and honored old age4 ,venereal 
excesses1 on the contrary1 undermine the

 vigor of the constitution1 bring on a  
host of bodily infirmities1 exhaust the 
system before the proper time1 debauch  
and degrade the mind and will1 and      
prepare their victims for an early grave
 or a decrepit old age4  ,,ii4 ,but how 
can a passion so ardent be properly     
restrained8 ,in particular1 what can a  
physician do to prevent the manifold    
injuries which1 if not properly         
controlled1 it will bring to his        
patients8 ,these are practical questions
 directly to our purpose4  ,the first   
requisite for all effective action is to
 have correct knowledge and strong      
convictions on a subject4 ,no one will  
check a passion with firmness if he have
 a lingering doubt as to whether1 after 
all1 he is strictly bound to restrain   
it4 ,as a man's mind matures1 at least  
if his mind be upright and not distorted
 by the strain of a ruling passion1 he  
understands more and more thoroughly    
that his perfection consists and his    
highest interests lie in obeying at all 

times the law of reason1 in maintaining 
his specific dignity of a rational      
being1 and not allowing himself to be   
controlled by passion1 the ruling power 
of brute animals4 ,besides1 he becomes  
aware in various ways of the evil       
results of immoral practices1 and he    
sees many reasons to keep his passions  
in check4 ,but young people have neither
 such experience nor such information1  
and they are not always wise enough to  
understand the imperative dictates of   
self-restraint4 ,and yet it is often in 
early years1 while body and mind are in 
the period of development1 that the most
 serious injury is done to the          
constitution and to the character by the
 indulgence of carnal pleasures4 ,habits
 are then engendered which become a real
 slavery2 so that later in life when    
there arises a sincere desire to stop   
such disgraceful practices1 there is a  
feeling of impotence to resist          
temptations which by one's own fault    
have become a second nature4  ,what then

 can be done with the young8 ,they must 
early and authoritatively be told of the
 wrong1 the sin of base self-indulgence1
 and of every practice that leads to it4
 ,if a beginning of immorality is       
discovered in a child1 it must be       
plainly told and emphatically warned of 
the serious consequences involved4 ,the 
child's mother is1 as a rule1 the best  
guide and director in infancy4 ,later   
on1 the ,doctor has frequent chances to 
do so2 it comes from him with better    
grace than from others2 and his warning 
is likely to be minded1 because it is   
clear that he knows and ought to know   
what he is talking about with regard to 
bodily consequences4 ,yet it is always a
 matter of delicacy2 and great care     
should be taken lest1 while pointing out
 the evil1 there be also a stimulus     
added to a prurient curiosity4  ,much   
good sense is required in any given case
 to decide whether more good or more    
evil is likely to result from the       
warning2 in doubt of success1 it is     

better to leave the matter alone4       
,where ignorance is bliss      ',tis    
folly to be wise4  ,the safest way of   
repressing the passion of lust is the   
provision that an all-wise ,providence  
supplies in ,religion1 in which ,god    
authoritatively forbids all immoral     
action and even all immoral coveting or 
desire4 ,positive dogmatic teaching on  
this subject is required1 especially    
with the young4 ,you cannot argue with  
them on this matter as you can with     
grown people4 ,that is one reason why   
religious teaching should permeate early
 education4 ,the ,decalogue should be   
the back-bone of a child's training3 and
 it should be proposed on the authority 
of ,god1 and explained so as to check   
not only sinful acts1 but also          
covetings1 prurient curiosity1 improper 
reading1 immodest looks and thoughts1 in
 a word1 whatever paves the way to the  
walks of sin4 ,the greatest of teachers 
has ,himself laid down the law in this  
matter3 it must be proposed as coming   

from ,his divine lips1 as it did3 ,i say
 to you that whosoever shall look on a  
woman to lust after her has already     
committed adultery with her in his heart
 7,st4 ,matt4 v4 #bh74 ,the lesson is   
enforced by these words of the great    
,apostle3 ,neither fornicators1 nor     
adulterers1 nor the effeminate 444 shall
 possess the kingdom of ,god 7#a ,cor4  
vi4 #i1 #aj74  ,true1 the child will not
 realize the full import of such        
lessons2 but he will understand it in   
due time2 and already in early years he 
will be warned against indulging his    
nascent passions4 ,it is well that the  
conscience should be early awakened in  
this matter2 for the more this passion  
is indulged1 the more it craves for     
further indulgence till it becomes      
almost uncontrollable4  ,,iii4 ,no      
possible evil to any individual man or  
woman can result from the firm control  
that one may acquire over the passion of
 lust4 ,on the contrary1 if it should be
 controlled all through life1 this would

 only add to a man's strength of mind1  
firmness of will1 soundness of body1 and
 length of life4 ,for in the school of  
morality1 in which every ,physician     
should be educated1 the leading         
principle is3 ,contraries are cured by  
contraries1 ,contraria contrariis       
curantur4 ,on this principle1 lust is   
most efficiently controlled by aiming1  
at least in youth1 at total abstinence  
from its indulgence4 ,you know that1 in 
the ,catholic ,church1 priests and      
religious lead a single life1 and pledge
 themselves for life to practise the    
most perfect control of the sexual      
passion4 ,what do you think is the      
result of their total abstinence on this
 point with regard to their length of   
days8 ,as a rule their life is much     
longer1 in normal circumstances1 than   
that of the other learned professions4  
,here are a few proofs4 ,in ,france1    
during the twenty years from #ahbc to   
#ahdc1 #gej priests died in the diocese 
of ,paris4 ,of these only #bjj were     

under sixty years old2 there were #eed  
between sixty and seventy years old1    
#ddh over seventy1 and #agg over eighty4
 ,again1 of #bjb ,carmelite nuns who    
died in a large convent of ,paris1 ,dr4 
,descuret1 the attending physician1     
states that #hb had lived over seventy  
years1 #bc over eighty years4 ,most     
,trappists and ,carthusians die of      
scarcely any other sickness than old    
age4 ,all young people who aspire to the
 clerical or religious profession learn 
from their early years the holiness and 
the loveliness of purity4 ,our ,church  
effects this result by placing before   
their youthful imaginations the most    
perfect of patterns of virtue1 the      
infant ,saviour1 the virgin ,mother1 the
 boy saints ,aloysius and ,stanislaus1  
the maidens ,agatha and ,cecilia1 and a 
whole phalanx of ,christian heroes and  
heroines4  ,i dwell the more willingly  
on this subject1 gentlemen1 because1    
besides protecting modesty in your young
 patients generally1 it may fall to the 

lot of some of you1 in the course of    
your professional careers1 to be        
attending physicians to religious       
houses2 and you will then appreciate the
 delicacy of the flowers of virtue that 
bloom beneath the shadow of the         
sanctuary4 ,certainly even there you may
 happen to find isolated cases of       
infidelity to duty2 for human nature is 
not angelic nature2 but in such abodes  
it comes near to it1 at least for the   
vast majority4  ,,iv4 ,on the other     
hand1 what sad havoc does not the sexual
 passion play where it is precociously  
developed and wantonly indulged4 ,dr4   
,h4 ,fournier1 one of the most eminent  
physicians of ,paris1 says3 ,there is   
not a vice more fatal to the            
conservation of man than masturbation4  
,this unfortunate habit is sometimes    
acquired by very little boys and girls4 
,foolish or vicious nurses may bring it 
on by handling young children most      
indelicately4 ,this is one of the many  
reasons why none but virtuous servants  

and nurses should be employed by wise   
parents and physicians4 ,in later years1
 children often learn this degrading and
 most injurious vice from their depraved
 companions1 some of whom seem even to  
regard the practice of it as a manly    
accomplishment4 ,when habitually        
indulged in1 it produces on the health  
and the strength of the constitution    
effects the most deplorable4 ,even the  
intellect is liable to become thereby   
enfeebled1 a want of virility is        
exhibited both in the body and in the   
mind of its victims2 then follows a loss
 of ambition and self-control4 ,when    
this morbid passion gets control of a   
person1 writes an experienced           
practitioner in medicine1 it is as      
though an unclean spirit had entered1   
subdued the will1 weakened the moral    
forces1 enfeebled the intellectual      
faculties1 lessened the power to resist 
temptation1 and overcome every obstacle 
opposed to its gratification4 ,even     
while the intellect is still clear1 and 

the sense of wrong keen1 the individual 
is a slave to this morbid impulse4      
,though the baneful effects may not     
always affect the physical health of the
 victim1 the unfortunate practice very  
often engenders in boys and girls       
tendencies which in later years lead to 
all the miseries conspicuous in houses  
of debauch and infamy4 ,but ,i need not 
dwell on consequences that belong to    
pathology rather than to ,jurisprudence4
  ,v4 ,confining myself to my sphere of 
what is morally right or wrong1 ,i must 
be permitted to point out some gross    
violations of duty in some members of   
your honored profession4 ,there are     
physicians so reckless of consequences  
and of principles alike as to advise at 
times the practice of illicit sexual    
intercourse4 ,let them beware2 they are 
doing a very unwise and guilty act4     
,even if an immoral practice should save
 a human life1 it may not be indulged1  
on the principle which must be by this  
time very familiar to your ears1 that   

the end does not justify the means4 ,and
 besides no good result can be expected 
from what is contrary to the law of     
nature and of nature's ,god4 ,it was to 
punish sins of the flesh that the       
,deluge was sent1 which destroyed nearly
 the whole human race4 ,all flesh had   
corrupted its way1 says the sacred      
historian4 ,it was to punish unlawful   
indulgence of lust that ,sodom and      
,gomorrha were destroyed by fire from   
heaven2 and the memory of these guilty  
cities is preserved in the very name of 
,sodomy4 ,onan1 as the same sacred      
volume relates 7,gen4 xxxviii71         
performed the marriage act in a manner  
to frustrate it of its legitimate       
purpose1 the generation of children1 and
 the ,lord slew him2 and his sin is to  
this very day branded with his name and 
called ,onanism4 ,and yet in ,christian 
lands physicians are found who will at  
times dare to recommend such practices  
to their patients4  ,on the occasions   
mentioned1 ,god punished the guilty     

miraculously2 but that is not ,his usual
 way4 ,he has so contrived our natures  
that sins committed against ,his laws in
 our bodies ordinarily bring a part of  
their punishment in their train1 not the
 less certain because slower in its     
operation than a miracle would be4 ,all 
the venereal diseases are there to act  
as earthy ministers of ,heaven's        
justice1 anticipating1 and often        
mercifully averting1 the punishments of 
the future world4  ,,vi4 ,besides       
private and secret tortures of body and 
mind1 a public and most deplorable      
calamity has descended of late on our   
own vigorous young nation1 as well as on
 some older lands1 threatening in the   
not distant future the extinction of    
many of its most esteemed families and  
of what was1 not long ago1 a vigorous   
stock4 ,the following article by ,dr4   
,walter ,lindley1 ,professor of         
,gynecology in the ,university of       
,southern ,california1 will explain the 
matter better than my words could do4   

,it was read in ,los ,angeles at a      
meeting of the ,southern ,californian   
,medical ,society in ,june1 #ahie1 and  
is printed in the ,n4 ,y4 ,medical      
,journal of ,august #ag of the same year
 7pp4 #baa and following74 ,it is headed
 ,american ,sterility2 ,i will quote    
freely from it3  ,the obstetrician finds
 his vocation disappearing among the    
,american women from the face of the    
earth4  ,it is a fact that the ,american
 family with more than one or two       
children is the exception4 ,from the    
records of six generations of families  
in some ,new ,england towns1 it was     
found that the families comprising the  
first generation had on an average      
between eight and ten children2 the next
 three generations averaged about seven 
to each family2 the fifth generation    
less than three to each family4 ,the    
generation now on the stage is not doing
 so well as that4 ,in ,massachusetts the
 average family numbers less than three 
persons4 ,in #ahhe the census of        

,massachusetts disclosed that #ga4bh per
 cent of the women of that ,state were  
childless4 ,the census of #ahhe in the  
,state of ,new ,york shows that         
twenty-five per cent of the women of    
that ,state are childless1 fifty per    
cent average less than one child1 and   
seventy-five per cent average only a    
trifle over one child4  ,southern       
,california has fully as dark a record  
as ,new ,england--that is1 in the family
 where the man and wife are             
,american-born4 ,it goes without saying 
that the medical profession in this     
country is composed to a great extent of
 typical progressive ,americans1 and ,i 
ask you to make mental statistics of the
 children in the families of the        
physicians in ,southern ,california1 and
 you will find very few of them         
containing more than two4  ,had the     
,rev4 ,t4 ,r4 ,malthus lived in the     
,united ,states to-day1 he would never  
have argued about the danger of         
over-population1 as he did in his       

interesting volume on ',the ,principles 
of ,population4'  ,after quoting the    
views of ,plato1 ,aristotle1 and        
,lycurgus1 ,dr4 ,lindley continues3 ,in 
,southern ,california there are1 it is  
true1 many children1 but the average    
,american family is very small4  ,as ,i 
sat writing this an evening or two ago1 
,i jotted down the names of twenty-five 
families of my acquaintance in ,los     
,angeles1 taking them as fast as ,i     
thought of them4 ,the list was composed 
entirely of professional and business   
men ranging in age from thirty-five to  
fifty4 ,all had been married quite a    
number of years4 ,the result of my      
memorandum was that in these twenty-five
 families there were but eighteen       
children4 ,these families were wholly   
unselected1 and are about the average   
,protestant ,american families outside  
the rank of laborers4  ,what are the    
causes of this small proportion of      
children8 ,disease1 preventives of      
conception1 and abortion form the       

trinity of responsibility in this grave 
condition4 ,it is true that the first   
cause 7disease7 results in many women   
being barren1 but ,i believe that you   
will agree with me that the last two    
causes1 preventives of conception and   
abortion1 are the two chief causes4     
,the ,a4 ,p4 ,a4 might find food for    
thought by investigating the infrequency
 of criminal abortion in ,catholic      
families in the ,united ,states4 ,it is 
the ,protestant or agnostic ,american   
who too often uses one of the           
preventives of conception4 7,here the   
,doctor refers to a foot-note in which  
he says3 ,i write this opinion as a     
,protestant1 and should be glad to learn
 that it is not well founded47 ,he      
continues3 ,if1 through inadvertence1   
pregnancy should occur1 then an abortion
 is in order4 ,disease and poverty and  
war and accident all work together to   
keep down the population1 but we are    
overcoming these4 ,plagues and          
pestilences are rare4 ,the number who   

die of starvation in ,california is very
 small1 while war has played but a small
 part4 ,through the diffusion of the    
laws of sanitation1 improved dietary1   
and advanced therapeutics1 the longevity
 of man is increasing1 but the ,american
 woman's aversion to child-bearing is   
blighting our civilization1 and can be  
well named the twentieth-century curse4 
,in this aversion the woman frequently  
echoes the wish of the husband4  ,a     
large proportion of the ,american young 
women who marry do so with the          
determination that they will have no    
children4 ,they are abetted in this     
notion by many elderly women4 ,the cure 
for this terrible sentiment is          
education4 ,the home1 the press1 the    
schoolroom1 and the pulpit should be    
centres for reviving the ancient idea of
 the nobility of motherhood4 ,the       
physician should not underestimate his  
influence4  ,by constantly bearing in   
mind the danger of the present          
tendencies1 he can do much to change the

 current4 ,let us hope that we shall    
again see the day when thoughtful       
motherhood shall be considered the      
highest function of womanhood1 and to   
shirk this natural duty will be deemed a
 disgrace4  ,gentlemen1 it would be easy
 to prove that this testimony of ,dr4   
,lindley is not that of an exceptional  
witness1 or a piece of special pleading2
 but it is the acknowledged conviction  
of the medical profession generally1    
confirmed by the last ,united ,states   
,census1 and in fact not questioned1 to 
my knowledge1 by any weighty authority4 
,as early as #aheg1 ,dr4 ,h4 ,b4        
,storer1 an eminent physician of        
,boston1 startled the community by      
publishing two books on this subject1   
entitled3 ,criminal ,abortion4 ,why     
not8--,a ,book for ,every ,woman2 ,is it
 ,i8--,a ,book for ,every ,man4 ,soon   
after1 ,rev4 ,john ,todd1 a ,protestant 
minister of ,pittsfield1 ,massachusetts1
 published a work styled ,serpents in   
the ,dove's ,nest1 all which works and a

 multitude of others tell the same tale 
of woe regarding the increase of        
child-destroying crimes in ,new         
,england1 chiefly among the old stock   
peculiarly called ,americans4 ,dr4      
,nathan ,allen1 of ,lowell1             
,massachusetts1 in his treatises1       
,changes in the ,new ,england           
,population and ,the ,new ,england      
,family1 gives overwhelming testimony4  
,harper's ,magazine 7quoted by the      
,catholic ,world for ,april1 #ahfi7     
remarks3 ,we are shocked at the         
destruction of human life on the banks  
of the ,ganges1 but here in the heart of
 ,christendom fticide and infanticide   
are extensively practised under the most
 aggravating circumstances4 ,we         
,catholics are not personally interested
 in this matter2 but the good of our    
fellow-men and chiefly our              
fellow-countrymen calls for the earnest 
exertion of us all to stop this dreadful
 evil4 ,all the works ,i have referred  
to exempt ,catholics from the blame     

pronounced2 the ,harper's ,magazine     
article referred to expressly says3 ,it 
should be stated that believers in the  
,roman ,catholic faith never resort to  
any such practices2 the strictly        
,americans are almost alone guilty of   
such crimes4 ,this matter is fully      
explained in a recent work called       
,catholic and ,protestant ,countries    
,compared1 by ,rev4 ,alfred ,young1     
,c4,p41 ch4 xxxii4  ,,vii4 ,now1        
gentlemen1 ,i am very much afraid that  
while physicians as a body abhor all    
such murders and openly condemn them1   
many do not show much repugnance to     
allow1 and even sometimes to suggest1   
such onanistic intercourse among married
 people as shall prevent the possibility
 of conception4 ,for instance1 if it    
happens that a young mother suffers much
 in her first confinement1 at once the  
suggestion is made that a second        
parturition may prove fatal4 ,from that 
moment regular intercourse is dreaded4  
,either onanism is habitually practised1

 or the husband becomes a frequent      
visitor to dens of infamy1 where to     
where to save his wife's health1 he     
encourages a traffic that leads         
multitudes of wretched girls to a       
premature and miserable death4 ,every   
one despises those outcasts of society2 
but are not the men who patronize them  
just as guilty8 ,probably enough1 if the
 imprudent suggestion about dangers of a
 second child-bearing had not been made 
by the ,doctor1 the young wife might    
have become the happy mother of a       
numerous family of healthy children4    
,for we must trust in ,divine           
,providence4 ,if a husband and wife do  
their conscientious duty1 there is a    
,god that provides for them and their   
family more liberally than for the birds
 of the air and the lilies of the field4
 ,and if ,he should so dispose that the 
worst should befall1 well1 such temporal
 clangers and sufferings as attend      
child-bearing are the lot of woman-kind1
 just as the dangers and hardships of   

the battlefield1 the mine1 the factory1 
the forest1 and the prairie are the lot 
of the men4  ,the man who shirks his    
duty to family or country is a coward2  
women1 as a rule1 are brave enough in   
their own line of duty1 and patiently   
submit to ,god's sentence pronounced in 
,paradise1 ,i will multiply thy sorrows 
and thy conceptions1 in sorrow shalt    
thou bring forth children 7,gen4 iii4   
#af71 just as they have to submit to the
 words immediately following3 ,thou     
shalt be under thy husband's power1 and 
he shall have dominion over thee4       
,certainly1 the husband of a delicate   
woman ought to spare her strength and   
restrain his passion1 but not at the    
sacrifice of morality2 and ,doctors     
ought to be very careful not to cause   
false or exaggerated alarms1 and thus   
make themselves to some extent          
responsible for untold moral evils4     
,they should remember that1 as a rule1  
the raising of a family is the principal
 purpose of a married life4 ,the        

happiness and virtue of the parties     
concerned depend chiefly on the faithful
 performance of this duty4 ,how sad is  
the lot of those--and they are many--who
 undertook in early years of married    
life to prescribe a narrow limit to the 
number of their children2 they had one  
or two1 and they would have no more1 and
 for this purpose criminally thwarted   
the purposes of nature4 ,then comes     
death and snatches away their solitary  
consolation3 and they spend their old   
age childless and loveless1 in mutual   
upbraidings and unavailing regrets4     
,how different is the lot of those aged 
couples--and they were many of yore1 and
 are yet in various nations--who are    
like patriarchs amid their crowds of    
children and grandchildren and          
great-grandchildren1 dwelling in mutual 
love and as if in a moral paradise where
 all domestic virtues bloom6  ,,viii4   
,true1 such families are usually the    
outcome of moderately early marriages2  
and many ,doctors nowadays disapprove of

 such unions as an evil4 ,a moral evil  
they certainly are not2 and the physical
 evils sometimes attending them must1 ,i
 think1 be traceable to a variety of    
causes2 for such evils are certainly not
 inseparable from early marriages4 ,as  
to their moral advantages1 ,mr4 ,wm4 ,e4
 ,h4 ,lecky1 in his ,history of         
,european ,morals1 writes of the ,irish 
people in particular3 ,the nearly       
universal custom of early marriages     
among the ,irish peasantry has alone    
rendered possible that high standard of 
female chastity1 that intense and       
jealous sensitiveness respecting female 
honor1 for which1 among many failings   
and some vices1 the ,irish race have    
long been pre-eminent in ,europe 7v4 i4 
p4 #adf74 ,and that he does not confine 
his statement to female chastity is     
evident from what he adds farther on3   
,there is no fact in ,irish history more
 singular than the complete and1 ,i     
believe1 unparalleled absence among the 
,irish priesthood of those moral        

scandals which in every ,continental    
country occasionally prove the danger of
 vows of celibacy4 ,the unsuspected     
purity of the ,irish priesthood in this 
respect is the more remarkable1 because1
 the government of the country being    
,protestant1 there is no special        
inquisitorial legislation to insure it1 
because of the almost unbounded         
influence of the clergy over their      
parishioners1 and also because1 if any  
just cause of suspicion existed1 in the 
fierce sectarianism of ,irish public    
opinion it would assuredly be magnified4
 ,considerations of climate are quite   
inadequate to explain this fact2 but the
 chief cause is1 ,i think1 sufficiently 
obvious4 ,the habit of marrying at the  
first development of the passions has   
produced among the ,irish peasantry1    
from whom the priests for the most part 
spring1 an extremely strong feeling of  
the iniquity of irregular sexual        
indulgence1 which retains its power even
 over those who are bound to perpetual  

celibacy 7p4 #adg74 ,no one will say1 ,i
 believe1 that the custom of early      
marriages in ,ireland has any injurious 
effects on the health of either parents 
or children4 ,nor need it necessarily   
have such effects on those of our       
,american young men and women who lead  
regular lives and are not enfeebled by  
unnatural vices or demoralized by dainty
 food and luxurious manners4  ,a wise   
physician has many proper ways of       
providing for the health and strength of
 both parents and children without      
advocating practices which are a snare  
for innocence4 ,let him insist with all 
his patients on the cultivation of      
healthful habits for the family and the 
individual2 wholesome and not           
over-delicate food2 moderation in eating
 and drinking2 regular and manly        
exercise1 especially in the open air2   
early hours for retiring and rising4    
,but1 above all--and this is directly to
 our present purpose--let him show the  
greatest regard for the laws of         

morality1 the main support of individual
 and social happiness4 ,his views upon  
such matters1 manifested alike in his   
conduct and his conversation1 but       
especially in his management of cases   
involving the application of moral      
principles1 will go far to influence the
 community in which he moves4 ,his task 
is to be a blessing to his fellow-men1 a
 source of happiness and security to    
individuals and to society4             
,,lecture ,,vi4  ,,the ,,physician',s   
,,professional ,,rights ,,and ,,duties4 
,gentlemen1 so far ,i have explained the
 duties which the physician has in      
common with all other men1 and which    
arise directly from the natural law     
independently of any civil legislation4 
,the natural law requires the ,doctor to
 respect the life of the unborn child1  
thus forbidding craniotomy and abortion4
 ,it also obliges him to protect his    
patients from the baneful effects of    
venereal excesses4 ,over these matters  
human law has no control1 except that it

 may and ought to punish such overt acts
 as violate the rights of individuals1  
or seriously endanger the public        
welfare4  ,we shall now consider the    
physician's natural rights and duties in
 regard to matters which civil and      
criminal legislation justly undertake to
 regulate4 ,one of the chief functions  
of civil authority is to provide for the
 observance of contracts4 ,now1 the     
physician in his professional services  
acts under a double contract1 a contract
 with the state and a contract with his 
individual patients4 ,by accepting his  
diploma of ,m4,d4 from the college      
faculty1 and indirectly from the civil  
authority1 he makes at least an implicit
 contract with the state1 by which he   
receives certain rights conditioned on  
his performance of certain duties4 ,in  
offering his services to the public1 he 
also makes an implicit contract with his
 patients by which he obliges himself to
 render them his professional services  
with ordinary skill and diligence on    

condition of receiving from them the    
usual compensation4  ,i4 ,the chief     
rights conferred on him by the state are
 these3  #a4 ,protection against all    
improper interference with his          
professional ministrations4  #b4        
,protection for his professional career 
by the exclusion of unauthorized        
practitioners4  #c4 ,immunity from      
responsibility for evil consequences    
that may result without his fault from  
his medical or surgical treatment of    
patients4  #d4 ,enforcement of his right
 to receive due compensation for his    
professional services4  ,these rights   
are not granted him arbitrarily by the  
state2 they are founded in natural      
justice1 but made definite and enforced 
by human legislation4 ,take1 for an     
example1 his right to receive due       
compensation for his services4 ,this    
right was not recognized by the old     
,roman law in the case of advocates and 
physicians1 nor by the common law of    
,england until the passing of the       

,medical ,act in #aheh4 ,surgeons and   
apothecaries could receive remuneration 
for their services1 but not physicians4 
,these were presumed to attend their    
patients for an honorarium or honorary1 
that is1 a present given as a token of  
honor4  ,certainly1 if ,doctors by      
common agreement waived their right to  
all compensation1 or agreed to be       
satisfied with any gift the patient     
might choose to bestow1 they would be   
entitled to honor for their generosity2 
but they are not obliged to such conduct
 on the principles of natural justice4  
,for by nature all men are equal1 and   
therefore one is not obliged1 under     
ordinary circumstances1 to work for the 
good of another4 ,if he renders a       
service to a neighbor1 equity or        
equality requires that the neighbor     
shall do a proportionate good to him in 
return4 ,thus the equality of men is the
 basis of their right to compensation   
for services rendered4 ,the physician's 
right to his fee is therefore a natural 

right1 and on his patient rests the     
natural duty of paying it4 ,not to pay  
the ,doctor's bill is as unjust as any  
other manner of stealing4  ,as to the   
amount of compensation to which the     
,doctor is justly entitled1 ,ewell's    
,medical ,jurisprudence remarks3 ,by the
 law of this country1 all branches of   
the profession may recover at law a     
reasonable compensation for their       
services1 the amount of which1 unless   
settled by law1 is a question for the   
jury2 in settling which the eminence of 
the practitioner1 the delicacy and      
difficulty of the operation or of the   
case1 as well as the time and care      
expended1 are to be considered4 ,there  
is no limitation by the common law as to
 the amount of such fees1 provided the  
charges are reasonable4 ,the existence  
of an epidemic does not1 however1       
authorize the charge of an exorbitant   
fee4  ,a medical man can also recover   
for the services rendered by his        
assistants or students1 even though the 

assistant is unregistered2 it is not    
necessary that there should be any      
agreed specified price1 but he will be  
allowed what is usual or reasonable4    
,it is not the part of the physician's  
business1 ordinarily1 to supply the     
patient with drugs2 if he does so he has
 a right to compensation therefor4 ,if  
the agreement is ,no cure1 no pay1 he   
cannot1 however1 even recover for       
medicines supplied1 if the cure is not  
effected4 ,his right to recover for     
professional services does not depend   
upon his effecting a cure1 or upon his  
service being successful1 unless there  
is a special agreement to that effect2  
but it does depend upon the skill1      
diligence1 and attention bestowed 7pp4  
#c and #d74  ,further details on this   
point belong more properly to the       
lecturer on ,medical ,law4 ,we are now  
concerned with the principles underlying
 special legislation4 ,the main         
principle regulating all compensation is
 that there shall be a sort of equality 

between the services rendered and the   
fee paid for them4 ,ignorant people     
sometimes find fault with the amount    
charged as a ,doctor's fee4 ,there may1 
of course1 be abuses by excess2 but men 
have no right to complain that a ,doctor
 will ask as much for a brief visit as a
 common laborer can earn in a day4 ,this
 need not seem unfair if it be          
remembered that the physician had to    
prepare1 during many years of primary1  
intermediate1 and professional studies1 
before he could acquire the knowledge   
necessary to write a brief prescription4
 ,besides1 it may be that his few       
minutes' visit is the only one that day2
 and yet he has a right to live in      
decent comfort on his profession        
together with those who depend on him   
for support4  ,we must1 however1        
remember1 on the other hand1 that       
excessive fees are nothing else than    
theft2 for theft consists in getting    
possession of another's property without
 just title4 ,the following rules of    

,dr4 ,ewell are sensible and fair3  ,the
 number of visits required must depend  
upon the circumstances of each          
particular case1 and the physician is   
regarded by the law as the best and     
proper judge of the necessity of        
frequent visits2 and1 in the absence of 
proof to the contrary1 it will be       
presumed that all professional visits   
made were deemed necessary and were     
properly made4  ,there must not be too  
many consultations4 ,the physician      
called in for consultation or to perform
 an operation may recover his fees from 
the patient1 notwithstanding that the   
attending physician summoned him for his
 own benefit1 and had arranged with the 
patient that he himself would pay4      
7,this1 of course1 does not mean that   
the practitioner has a right thus to    
shift the burden of pay from his own    
shoulders47 ,where a medical man has    
attended as a friend1 he cannot charge  
for his visit4 ,where a tariff of fees  
has been prepared and agreed to by the  

physicians of any locality1 they are    
bound by it legally as far as the public
 are concerned 7that is to say1 they    
cannot charge more than the tariff      
rates71 and morally as far as they      
themselves are concerned 7p4 #e74  ,in  
these rules ,dr4 ,ewell regards chiefly 
what conduct the courts of justice will 
sustain4 ,it is evident that the ,doctor
 is never entitled to run up his bill   
without any benefit to his patient2     
where there is no service rendered at   
all1 there can be no claim to           
compensation4 ,still it is not necessary
 that actual benefit has resulted to the
 patient2 it suffices for the claim to  
the fee that measures have been taken   
with a view to such benefit4 ,even when 
no physical advantage can reasonably be 
hoped for from the visit1 the           
consolation it affords the patient and  
his friends may render those who are to 
bear the expense fully willing that it  
should be often repeated and1 of course1
 charged on the bill4 ,provided care be 

taken that they understand the          
situation1 no injustice is done them4   
,scienti et consentienti non fit injuria
 is a good moral maxim4  ,,ii4 ,we have 
said that the rights conferred on the   
physician by the state are conditioned  
on his performing certain duties4 ,he   
owes the same duties to his patients in 
virtue of the contract1 explicit or     
implicit1 that he makes with them by    
taking the case in hand4 ,under ordinary
 circumstances1 neither the state nor   
the patients can oblige him to exercise 
his profession at all2 but1 if once he  
has taken a case in hand1 he can be     
justly held not to abandon it till he   
has given his patient a fair opportunity
 of providing another attendant2 even   
the fear of contagion cannot release him
 from that serious obligation4  ,the    
duties arising from the physician's     
twofold contract1 with the state and    
with his patients1 are chiefly as       
follows3  #a4 ,he must acquire and      
maintain sufficient knowledge of his    

profession for all such cases as are    
likely to come in his way4 ,no ,doctor  
has the right to attempt the management 
of a case of which he has not at least  
ordinary knowledge4 ,in matters of      
special difficulty1 he is obliged to use
 special prudence or ask for special    
consultation4 ,the courts justly hold   
him responsible for any serious injury  
resulting from gross ignorance2 in such 
cases they will condemn him for         
malpractice4 ,i would here remark that1 
in an age in which the science of       
medicine is making such rapid progress1 
every ,doctor is in duty bound to keep  
up with the improvements made in general
 practice1 and in his own specialty if  
he has one4  #b4 ,a second duty is that 
of proper diligence in treating every   
single case4 ,many a patient suffers    
injury to health or even loses his life 
in consequence of a ,doctor's neglect4  
,gross negligence is an offence that    
makes him punishable by the court1 if it
 results in serious injury4 ,but even if

 such injury cannot be juridically      
proved1 or has been accidentally        
averted1 the moral wrong remains and is 
to be settled with the all-seeing       
,judge4 ,still1 in ordinary ailments1 no
 one is obliged to take more than       
ordinary trouble4  #c4 ,a third duty of 
the physician is to use only safe means 
in medical and surgical practice4 ,he   
has no right to expose his patient to   
needless danger4 ,what is to be thought 
of the use of such remedies as will     
either kill or cure8 ,they cannot be    
used as long as safer remedies are      
available and capable of effecting a    
cure2 for neither ,doctor nor patient   
has a right to expose a human life to   
unnecessary risk4 ,but when no safer    
remedies are going to effect a cure1    
then prudence itself dictates the       
employment of the only means to success4
 ,in such a case1 however1 the patient1 
or his parents or guardian1 should1 as a
 rule1 be informed of the impending     
danger1 so that they may give or refuse 

their consent if they please4 ,for1 next
 to ,god1 the right to that life belongs
 to them rather than to the physician4  
,the same duty of consulting their      
wishes exists when not life but the     
possible loss of a limb is at stake1 or 
the bearing of uncommon sufferings4     
,moralists teach that a man is not      
obliged in conscience to submit to an   
extraordinarily painful or revolting    
operation even to save his life4        
,certainly1 when the natural law leaves 
him at liberty1 the physician cannot    
compel him to submit to his dictation2  
all he can do is to obtain his consent  
by moral persuasion4  #d4 ,as a         
consequence from the ,doctor's duty to  
use only safe means it follows that he  
cannot experiment on his patients by the
 use of treatment of which he does not  
know the full power for good or evil4   
,nor is he excused from responsibility  
in this matter by the fact that the     
experiment thus made on one patient may 
be very useful to many others4 ,his     

contract is with the one now under      
treatment1 who is not willing1 as a rule
 to be experimented upon for the benefit
 of others4 ,and even if the patient    
should be willing1 the ,doctor cannot   
lawfully expose him to grievous danger  
unless it be the only hope of preserving
 his life4 ,this follows from the       
principle explained before1 that human  
life belongs chiefly to ,god and not to 
man exclusively4  #e4 ,there are various
 kinds of medical treatment to which we 
can scarcely have recourse without      
exposing ourselves to serious evil      
consequences4 ,such is the use of       
cocaine1 morphine1 and even in special  
cases of alcohol4 ,the drugs in         
themselves are useful1 but they often   
lead to evil results4 ,now in the use of
 all such drugs as are apt to be        
beneficial in one way and injurious in  
another1 we must ever be guided by the  
rules formerly explained concerning evil
 indirectly willed1 or rather permitted 
to result1 while good results are       

directly willed or intended4 ,if the    
,doctor is satisfied that a dose of     
morphine or an application of cocaine   
will do more good than harm1 he can1 of 
course1 prescribe or apply it4 ,still in
 such matters he must remember that the 
good effect is but temporary1 while its 
pernicious consequences1 especially when
 habits are thus contracted1 are likely 
to be permanent and cumulative4         
,besides1 the good results affect the   
body only1 the evil often affect body   
and soul4 ,many a wreck in health and   
morals has been caused by imprudent     
recourse to dangerous treatment1 where a
 little more patience and wisdom would  
have been equally efficient in curing   
the bodily ailment1 without any         
deleterious consequences4 ,if once a    
patient becomes a slave to the morphine 
or cocaine habit1 the only cure is to   
cut off all the supply of the drug      
either at once or1 at any rate1 by daily
 diminution4 ,to leave him free control 
of the poison is to co-operate in his   

self-destruction4  #f4 ,the sixth duty  
of a ,doctor is of a different kind4    
,there exists a tacit or implicit       
contract between him and his patients   
that he shall keep their secrets of     
which he becomes possessed in his       
professional capacity4 ,it is always    
wrong wantonly to betray the secrets of 
others2 but the ,doctor is bound by a   
special duty to keep his professional   
secrets2 and it is doubly wrong and     
disgraceful in him to make them known4  
,for instance1 if he has treated a case 
of sickness brought on by sinful        
excesses of any kind1 he is forbidden by
 the natural law to talk about it to    
such as have no special right to know   
the facts4 ,parents and guardians are   
usually entitled to be informed of their
 children's and their wards'            
wrong-doings1 that they may take proper 
measures to prevent further evil4       
,besides1 the ,doctor is properly in    
their service2 he is paid by them1 and1 
therefore1 his contract is with them    

rather than with the children4 ,he can1 
therefore1 prudently inform them of what
 is wrong1 but he cannot inform others4 
,it is a debated question in ,medical   
,jurisprudence whether the ,doctor's    
professional knowledge of criminal acts 
should be privileged before the courts1 
so that he should not be forced to      
testify to a crime that he has learned  
from his patients while acting as their 
medical adviser4 ,dr4 ,ewell speaks thus
 on the subject 7p4 #b73 ,the medical   
witness should remember that1 by the    
common law1 a medical man has no        
privilege to avoid giving in evidence   
any statement made to him by a patient2 
but when called upon to do so in a court
 of justice1 he is bound to disclose    
every communication1 however private and
 confidential1 which has been made to   
him by a patient while attending him in 
a professional capacity4 ,by statute1   
however1 in some of the ,united ,states1
 communications made by a patient to a  
physician when necessary to the         

treatment of a case are privileged2 and 
the physician is either expressly       
forbidden or not obliged to reveal them4
 ,such statutes exist in ,arkansas1     
,california1 ,indiana1 ,iowa1 ,ohio1    
,michigan1 ,minnesota1 ,missouri1       
,montana1 ,new ,york1 and ,wisconsin4   
,the seal upon the physician's lips is  
not even taken away by the patient's    
death4 ,such communications1 however1   
must be of a lawful character and not   
against morality or public policy2      
hence1 a consultation as to the means of
 procuring an abortion on another is not
 privileged1 nor would be any similar   
conference held for the purpose of      
devising a crime or evading its         
consequences4  ,a report of a medical   
official of an insurance company on the 
health of a party proposing to insure   
his life is not privileged from         
production2 nor is the report of a      
surgeon of a railroad company as to the 
injuries sustained by a passenger in an 
accident1 unless such report has been   

obtained with a view to impending       
litigation4  ,the practical rule for a  
,doctor's conscience on the subject of  
secrecy is1 that he must keep his       
professional secrets with great         
fidelity1 and not reveal them except in 
as far as he is compelled to do so by a 
court of justice acting within its legal
 power or competency4 ,if so compelled1 
he can safely speak out2 for his duty to
 his patient is understood to be        
dependent on his obedience to lawful    
authority4  ,as to the question of      
,jurisprudence whether the courts ought 
to treat the physician's official       
secrets as privileged1 in the same way  
as they do a lawyer's secrets1 this will
 depend on the further question whether 
the same reasons militate for the one as
 for the other4 ,the lawyer's privilege 
is due to the anxiety of the state not  
to condemn an innocent man nor a guilty 
man beyond his deserts4 ,to avert such  
evil1 the accused party needs the       
assistance of a legal adviser who can   

guide him safely through the mazes and  
technicalities of the law1 and1 even    
should he be guilty1 who can protect him
 against exaggerated charges and ward   
off unmerited degrees of punishment4    
,now1 this can scarcely be accomplished 
unless the attorney for the defence     
learn from his client the entire truth  
of the facts4 ,but the client could not 
safely give such information to his     
lawyer if the latter's professional     
secrets were not held sacred by the     
court of justice4  ,can the same reasons
 or equivalent ones be urged in behalf  
of the physician8 ,i do not see that    
they can4 ,and ,i notice besides that1  
if he be excused from testifying against
 his patients1 all their servants and   
attendants would seem to be entitled to 
the same privilege4 ,many persons1 ,i   
think1 labor here under a confusion of  
ideas2 a ,doctor is as sacredly bound to
 keep his patients' secrets as a lawyer 
is in regard to his clients1 but it does
 not follow that the law cannot grant a 

privilege to the one and refuse the same
 to the other1 for reasons which require
 it in the case of the lawyer and not in
 that of the ,doctor4  ,,iii4 ,besides  
the rights and duties which arise for   
the physician from his contracts with   
the state and with his patients1 there  
are other claims on his conscience1     
which proceed from his character as a   
man1 a ,christian1 and a gentleman4  #a4
 ,as a man1 he is a member of the human 
family1 not a stranger dwelling amid an 
alien race1 but a brother among         
brothers4 ,he cannot say1 as did the    
first murderer1 ,cain1 ,am ,i my        
brother's keeper8 ,but rather he must   
carry out the behest of the great       
,father of the human family3 ,god has   
given to each one care of his neighbor4 
,the maxim of ,freemasons is that every 
member of that secret society must come 
to the assistance of every brother-mason
 in distress4 ,but the law of nature and
 of nature's ,god is wider and nobler2  
it requires every man to assist every   

fellow-man in grievous need4 ,the rich  
glutton at whose door lay ,lazarus dying
 of want was bound1 not by any human but
 by the higher law1 to assist him2 and  
it was for ignoring this duty that the  
soul was buried in hell1 as the gentlest
 of teachers expresses it4  7a7 ,as     
physicians1 as men1 you will have duties
 to the poor1 who cannot pay you for    
your services2 they are your fellow-men4
 ,their bill will be paid in due time4  
,he is their security who has said3     
,whatsoever you have done to the least  
of these1 you have done it unto ,me4 ,he
 may pay you in temporal blessings1 or  
in still higher favors1 if you do it for
 ,his sake2 but pay ,he will1 and that  
most liberally3 ,i will repay1 says the 
,lord4 ,the rule of charity for         
physicians is that they should willingly
 render to the poor for the love of ,god
 those professional services which they 
are wont to render to the rich for      
pecuniary compensation4 ,while thus     
treating a poor patient they should be  

as careful and diligent as they would be
 for temporal reward2 what is done for  
,god should not be done in a slovenly   
fashion4  7b7 ,in this connection of    
regard for the poor1 allow me also to   
call your attention1 gentlemen1 to a    
point which students of medicine are apt
 to forget at times1 and yet which both 
,god and the world require you ever to  
bear in mind3 it is the respect which   
every man owes to the mortal remains of 
a departed brother4 ,i do not know that 
a people has ever been found1 even among
 barbarians1 who did not honor the      
bodies of their dead4 ,for the good of  
humanity1 dead bodies may at times be   
subjected to the dissecting-knife1 but  
never to wanton indignities4 ,reason    
tells you to do by others as you wish to
 be done by1 and ,revelation adds its   
teaching about a future resurrection and
 glorification of that body of which the
 ,apostle says that it is sown in       
dishonor1 but it shall rise in glory4   
,be men of science1 but be not human    

ghouls4 ,there is such a thing as       
retribution4 ,but lately a former       
millionaire died in a poorhouse and left
 his body as a cadaver for medical      
students4 ,we cannot afford to ignore   
the mysterious ways of ,divine ,justice4
 ,ever handle human remains in a humane 
manner2 and as soon as they have        
answered the purpose of science1 see    
that they be decently interred1 if      
possible4  #b4 ,there are other duties  
that you owe not as men but as          
,christians4 ,all of us enjoy the       
blessings of ,christian civilization1   
even those who are not ,christians      
themselves4 ,we are dealt with by others
 on ,christian principles1 and we ought 
to treat others in the same spirit4     
,what duties does this impose8  7a7     
,when your patients are in real danger  
of death1 let them have a good chance to
 prepare properly for their             
all-important passage into eternity4    
,give them fair warning of their        
situation4 ,doctors and relations are   

often afraid of alarming the patients   
and thus injuring their health4 ,but    
those who attend ,catholic patients at  
least soon find out by experience that  
the graces and consolations of the ,last
 ,sacraments usually bring a peace of   
mind that benefits even the bodily      
health4 ,in any case1 the interests of  
the future life are too important to be 
ignored4  7b7 ,for the same reason1 the 
physician should not prescribe such     
doses of morphine or other ansthetics as
 will render the patient unconscious at 
a time when he ought to be preparing to 
meet his ,judge4 ,this would be not     
kindness but cruelty4 ,a little         
suffering more in this life may save    
much suffering in the next4 ,if a       
,catholic priest1 on being called to a  
patient's bedside1 finds that the       
family's physician has been so          
inconsiderate1 he cannot help protesting
 against employing such a man in        
,catholic families4  7c7 ,if you attend 
a woman in childbirth1 you may be asked 

by a ,christian mother not to let her   
child die without ,baptism4 ,the vast   
majority of ,christians believe that    
this sacrament is necessary to obtain   
supernatural happiness4 ,the ceremony is
 easily performed3 no harm can come of  
it1 but immeasurable good for eternity4 
,it should properly be performed by the 
clergy4 ,but if this cannot be done1 any
 man1 woman1 or child1 even one not a   
,christian himself1 can administer the  
sacrament4 ,every ,doctor in a          
,christian land should understand how to
 do it1 and do it with unerring         
accuracy4 ,it were a disgrace for him to
 be ignorant of what even an ordinary   
child is expected to know4 ,the ceremony
 is so simple2 and yet1 being an        
institution of ,christ1 no man can      
modify it to suit his notions2 if what  
is done is not just what ,christ        
appointed to be done1 it will be of no  
avail4 ,notice1 therefore1 carefully    
every detail4 ,you will take a little   
water1 say a cupful1 real water--cold or

 lukewarm1 that matters not--you will   
slowly pour it on the head of the child1
 and1 while you do so1 you will say1 ,i 
baptize thee in the name of the ,father1
 and of the ,son1 and of the ,holy      
,ghost4 ,that is all4 ,notice1 you must 
say the words while the water is being  
poured on the child4 ,for ,i baptize    
means ,i wash2 pour1 therefore1 or wash 
while you say1 ,i wash4 ,should you     
hereafter wish to refresh your memories 
on this matter1 you can do so by        
consulting the ,century ,dictionary1    
which explains ,baptism1 and in         
particular ,catholic ,baptism1 as       
consisting essentially in the           
application of water to the person      
baptized by one having the intention of 
conferring the sacrament1 and who       
pronounces at the same time the words1  
',i baptize thee in the name of the     
,father1 and of the ,son1 and of the    
,holy ,ghost4' ,if a cup of water given 
to the thirsty brings a blessing1 how   
much more the giving of the water of    

salvation6 ,should it happen that the   
child is in danger of dying before      
delivery1 it should be baptized in the  
womb provided it be at all possible to  
cause the water to reach or wash its    
body1 projected upon it by any          
instrument whatever2 but the water      
should flow over the body1 not merely   
over the cyst enclosing it1 for the cyst
 is no part of the child4 ,even if but  
an arm or other minor portion of the    
body is washed1 the baptism is probably 
valid4 ,if any doubt about the valid    
administration is left1 the infant after
 delivery should be carefully baptized  
under condition1 as it is called2 that  
is1 with the condition added that1 if   
the former ceremony was validly         
conferred1 there is no intention of     
giving a second baptism4 ,for that would
 not be right2 since the sacrament      
cannot be validly received more than    
once2 it is a sacred initiation1 but it 
were mockery to initiate one that is    
already initiated4  ,should a physician 

be present when a pregnant woman has    
recently expired1 and the child may     
still be living in the womb1 it will be 
an easy and important task to perform   
the ,cesarean section as soon as        
possible1 and baptize the little one    
before it dies4 ,in all this there is no
 money1 but what is far more precious1  
the securing of eternal happiness4 ,i   
add with great pleasure that many       
physicians are wont to comply with all  
these instructions most carefully1 and  
even to instruct midwives and nurses in 
the best manner of rendering such       
services4  #c4 ,lastly1 we must consider
 the duties which a ,doctor owes to     
others and to himself as a gentleman4   
,it may not be easy to define what is   
meant by a gentleman1 and yet to some   
extent we all know it2 we recognize a   
gentleman when we meet one1 we pay him  
sincere homage in our hearts4 ,we       
readily allow him to influence us and to
 guide us4 ,we esteem him instinctively 
as a superior being1 as we distinguish a

 precious stone from a common pebble2 so
 we value a gentleman for precious      
qualities exhibited in the beauty of his
 conduct4 ,his conduct ever exhibits two
 characteristic marks3 a proper degree  
of dignity or respect for self1 and a   
proper degree of politeness or respect  
for others4 ,self-respect will not allow
 him to do anything which is considered 
vulgar1 unmannerly1 gross1 rude1 or     
selfish2 he will avoid the two extremes1
 of self-neglect on the one hand and    
self-display on the other4 ,his respect 
for others will make him treat all      
around him so as to make them feel      
comfortable in his presence2 he will    
avoid whatever gives pain or causes     
embarrassment to even the lowest member 
of society4  ,gentlemanliness has much  
to do with every one's success in life1 
and in particular with a ,doctor's      
success4 ,it is especially when sick    
that we are sensitive to everything     
displeasing in the conduct of others4   
,it is not then the bold thinker or the 

extensive reader that is the acceptable 
visitor to the sick-room2 but the       
gentlemanly consoler who always says the
 right thing at the right time1 whose   
very eye expresses and whose countenance
 reflects the thought and sentiment most
 appropriate on the occasion4  ,there   
are most able physicians who are not    
gentlemen1 and there are in the medical 
profession gentlemen who are rather poor
 physicians2 but as a rule1 ,i believe1 
the gentleman will thrive where the     
genius will starve4 ,it is more or less 
the same in other professions4 ,i know  
learned lawyers to-day who are far from 
prosperous1 while men ten times their   
inferiors in learning are getting rich4 
,i remember a most skilful physician1   
now no more on earth1 who was a very    
genius in the science of medicine2 but  
he was so filthy in his habits1 he would
 so unceremoniously chew tobacco at all 
times1 that many dreaded his visits1 and
 would sooner have a man of less ability
 but gentler manners as their family    

physician4  ,gentlemen1 habits good and 
bad cannot be put on and off like a     
dress-coat2 they are lasting qualities1 
the growth of years1 the result of      
constant practice and self-denial or    
self-neglect4 ,and1 as ,i wish you      
success in life1 allow me to conclude   
this lecture by recommending to you the 
assiduous cultivation of gentlemanly    
habits4 ,cultivate them now1 while you  
are preparing for future labors4 ,you   
wrong yourselves1 and you insult your   
companions and your professors1 when you
 neglect in their presence the          
conventionalities of polite society4    
,uniting the external decorum of a      
gentleman with a thorough knowledge of  
your profession1 and with what is still 
more important1 the virtues of a        
conscientious man and a sincere         
,christian2 ever true to the sound      
principles of morality which ,i have    
endeavored to explain and to inculcate  
in these lectures3 you will be an honor 
to yourselves1 an ornament to your noble

 profession1 the glory and joy of your  
,alma ,mater1 a blessing to the         
community in which ,providence will cast
 your lot as the dispensers of health   
and happiness and length of days to your
 fellow-men4     ,,lecture ,,vii4  ,,the
 ,,nature ,,of ,,insanity4   ,the       
subject of the present lecture1         
gentlemen1 is ,insanity4  ,i4 ,this     
subject belongs to a course of ,medical 
,jurisprudence1 because a physician who 
treats patients for insanity is liable1 
from time to time1 to be cited before a 
court of law either as a witness or as  
an expert4 ,his conduct in such cases is
 to be guided by the principles of      
natural and legal justice4  ,various    
important cases at law turn upon the    
question of a person's soundness of     
mind2 and frequently the medical expert 
has it in his power to furnish the court
 with more reliable information in this 
matter than any one else4 ,at one time1 
the validity of a last will may be      
contested1 and the possession of a      

fortune by one party or another may     
hinge on the question whether the       
testator at the time of making his will 
was in sufficient possession of his     
mental powers to perform an act of so   
much consequence4  ,at another time1    
interested parties may plead for or     
against the validity of a sale or other 
bargain made by a person of doubtful    
competency of mind2 or a life-insurance 
company may be interested in            
ascertaining the mental condition of an 
applicant for membership2 or it may be  
questioned whether the payment of an    
insurance policy is due to the family of
 a suicide1 the doubt depending for     
solution on the sound or unsound        
condition of his mind at the moment of  
the fatal act4 ,again1 there may be a   
real or pretended doubt whether a       
certain property-owner is so far        
demented as to be unfit to manage his   
estate2 or whether he needs a guardian  
to take care of his person2 or it may   
even seem necessary to confine him in a 

lunatic asylum4 ,there may be objections
 raised to the mental soundness of a    
witness in a civil or a criminal suit2  
or1 finally1 a criminal prosecution will
 depend mainly on the sanity or insanity
 of the culprit at the moment when the  
crime was committed2 as was the case    
with a ,prendergast and a ,guiteau4     
,you see1 then1 gentlemen1 that         
important interests are dependent on the
 thorough and correct understanding of  
this matter2 and therefore much         
responsibility rests upon the experts   
consulted in such cases3 property1      
honor1 liberty1 nay1 even life itself   
may be at stake4  ,that cases involving 
an insane condition of mind must be of  
frequent occurrence1 both in the medical
 and in the legal professions1 is       
apparent from the large and rapidly     
increasing amount of lunacy in our      
modern civilization4 ,wharton and       
,still's ,medical ,jurisprudence states 
7sec4 #ggj1 note7 that in #ahej there   
was in ,great ,britain one lunatic to   

about one thousand persons2 only thirty 
years later the ,lunacy ,commission of  
,great ,britain reported one lunatic to 
#ceg persons in ,england and ,wales1    
that is1 nearly three times as many4 ,in
 ,new ,york there is one to #chd        
persons4 ,it appears certain that its   
increase of late is out of all          
proportion to the increase of           
population2 and even though ,i see      
reasons to distrust somewhat the figures
 quoted for ,england1 enough is known to
 create serious alarm regarding the     
fruits of modern manners and customs on 
the minds of thousands4 ,this fact makes
 the matter of insanity very important  
for the medical and the legal student4  
,,ii4 ,still it must be noted that the  
responsibility of deciding cases of     
lunacy does not rest chiefly with the   
medical expert4 ,in cases of doubtful   
insanity the decision is to be given not
 by the ,doctor but by the court of     
justice4 ,except on very special        
occasions1 as when a physician is       

appointed on a committee or commission  
of inquiry1 he appears before a court   
either as an ordinary witness1 stating  
what facts have fallen under his        
personal observation2 or as an expert1  
explaining the received opinion of      
medical men with regard to cases of a   
certain class4 ,even though he feels    
convinced that the culprit or the       
patient is as mad as a ,march hare1 the 
physician cannot expect that his        
statement to that effect will be        
received as decisive4 ,it is for the    
judge to instruct the jury what kind or 
degree of insanity will excuse a culprit
 from legal punishment1 or will         
disqualify a person from testifying as a
 witness1 or from being a party to a    
civil contract in certain cases2 and it 
is for the jury to decide whether1 in   
the case in hand1 the fact of such      
insanity exists or not4 ,in criminal    
cases1 the jury pronounces on the double
 question1 whether the accused did the  
act charged to him1 and whether he has  

been juridically proved to have been    
accountable for the act under the laws  
as expounded by the judge4  #a4 ,to come
 to a decision on this double question1 
the jury might need to hear the facts   
stated which the physician has          
personally observed1 and of which he is 
summoned to be a sworn witness4 ,in such
 a situation all that is required of the
 ,doctor is that he shall give a most   
faithful and intelligent account of the 
facts4  ,it would disgrace his standing 
in society if any fault could be found  
with his testimony2 and1 as a sworn     
witness1 he is bound in conscience1 like
 any other witness1 to state the truth1 
the whole truth1 and nothing but the    
truth4 ,this is always the case when the
 purpose of the inquiry is the discovery
 of the sane or insane condition of a   
person's mind4 ,but if the inquiry      
concerns the performance of the guilty  
act1 the commission of the crime1 many  
,states of the ,union1 as explained     
before1 consider the ,doctor's          

professional secrets as privileged1 just
 like those of the lawyer and the       
clergyman2 i4e41 the ,doctor must not   
use against his patient any knowledge he
 has become possessed of while acting as
 his medical adviser4  #b4 ,when the    
physician appears before a court or     
commission as an expert1 he is expected 
to give the views of the medical        
profession upon hypothetical cases      
resembling the one under examination1   
and the scientific reasons and          
authorities on which those views are    
advanced4  #c4 ,but here a considerable 
difficulty presents itself2 it is so    
serious that1 owing to it1 the weight of
 the medical expert's testimony with    
judge and jury is often much less than  
could reasonably be desired4 ,the       
difficulty is to ascertain what really  
are the views of the medical profession 
on any given subject4 ,of course no     
individual ,doctors can put themselves  
up as representing the convictions of   
the medical profession1 nor can they    

always appeal to the unanimous agreement
 of their leading men4 ,leading         
physicians1 unfortunately1 are far from 
entertaining concordant views on many   
most vital questions4 ,it is this want  
of agreement that has made the testimony
 of experts so powerless to sway the    
minds of judge and jury4  ,the medical  
profession has no organization through  
which it can pronounce judgment4 ,in    
fact1 many of its most conspicuous      
members have adopted principles at      
variance with the deepest convictions of
 mankind generally2 such1 for instance1 
are the followers of ,darwin1 ,huxley1  
,maudsley1 and similar agnostic and     
materialistic leaders of modern thought4
  #d4 ,what still further diminishes the
 credit of medical experts is the fact  
that1 both in civil and criminal trials1
 they are summoned either by the defence
 or by the prosecution1 and are thus    
naturally selected1 not on account of   
their thorough knowledge1 but on account
 of their peculiar views known          

beforehand to the parties citing them4  
,thus their testimony is likely to be   
partial to either side1 and is          
distrusted2 at least it fails to command
 perfect confidence4 ,the only way in   
which the prejudices thus created       
against the physician can be overcome is
 by his acquiring thorough knowledge of 
his specialty1 and showing himself on   
all occasions to be as honorable and    
faithful as he is evidently experienced 
and intelligent4  #e4 ,the medical      
profession could be brought to be much  
more useful to society for the discovery
 of insanity if we could have here      
something like what exists in some parts
 of ,germany4 ,the practice obtains     
there of requiring the medical faculty  
of each judicial district to appoint a  
special committee1 to which questions of
 this kind are referred4 ,this committee
 is examined directly by the court1 and 
gives testimony somewhat in the same    
way1 and with the same effect1 as would 
a common-law court when reporting its   

judgment in a feigned issue from        
chancery1 or as would assessors called  
upon under the canon law to state1 in   
proceedings under the law1 what is the  
secular law of the land on the pending  
question 7,wharton and ,still1 sec4     
#bgd74  ,the matter of introducing some 
such practice into this country has been
 agitated of late1 and may by and by    
lead to beneficial results4 ,dr4 ,shrady
 has taken steps to promote this object 
by striving to have a law enacted by the
 ,new ,york legislature providing for   
the regulation of expert medical        
testimony in jury trials4 ,according to 
his plan1 once such a commission has    
been established1 the court is to send  
the medical issue to these experts1 just
 as it sends other issues to special    
juries to be decided4 ,the regular petit
 jury will then decide only upon the    
facts constituting the crime4  ,this    
would do away with special pleas of     
insanity before a jury that knows little
 or nothing about the nature of the     

disease1 and whose sympathies may       
readily be worked upon by shrewd lawyers
 to render a verdict of acquittal4  ,as 
things are now1 the medical expert1     
summoned to testify in a case of        
contested sanity or insanity of mind1   
ought to rise above minor               
considerations1 and promote the cause of
 justice1 by giving all the valuable    
information that his profession enables 
him to acquire on the very difficult    
subject of mental unsoundness4  #f4 ,for
 this purpose1 he must be skilled in    
three departments of science4  7a7 ,in  
law--sufficiently to understand what are
 considered by the courts as            
characteristic marks of an insane mind1 
and what amount of sanity the courts    
require to hold a culprit responsible   
for his crime or a contract valid in its
 effects4  7b7 ,in psychology--to such  
an extent that the expert witness can   
speak analytically and correctly as to  
the properties and actions of the human 
mind4  7c7 ,in medicine--so far as      

concerns the treatment of the insane1   
and the understanding of their          
peculiarities1 so as to reason from them
 by induction to the real condition of  
the client's or patient's mind4  ,but   
the main requisite for an expert witness
 is to understand clearly in what       
insanity properly consists1 and how far 
it ought to excuse an insane man from   
bearing the consequences of his acts4   
,,iii4 ,this two-fold knowledge is      
obtained by the psychological study of  
insanity1 on which study we are now to  
enter1 and it is the principal point in 
this whole matter4  ,insanity means a   
want of soundness2 he is insane whose   
mind is not sound1 but is deranged1 and 
therefore1 like a machine out of order1 
it cannot properly perform its specific 
task1 namely1 to know the truth of      
things4 ,an insane man cannot judge     
rightly4  #a4 ,insanity takes various   
forms1 which may be reduced to two      
kinds1 with the doubtful addition of a  
third kind1 namely1 moral insanity1 of  

which we shall speak in our next        
lecture4  ,the first kind consists in   
the total want or gross torpor of mental
 activity4 ,when there is a total1 or   
nearly total1 eclipse of the intellect1 
the disease is called idiocy1 the state 
of an idiot4 ,when there is an          
abnormally low grade of the reasoning   
power1 it is styled imbecility4 ,the    
failure or decay of reason in old age is
 called dotage4  ,the second kind of    
insanity is called illusional or        
delusional4 ,in it the intellect is not 
impotent2 on the contrary1 it is often  
unusually active2 but its action is     
abnormal1 its conclusions are false4    
,not that it reasons illogically or     
draws conclusions which are not         
contained in the premises4 ,very keen   
logicians may be demented4 ,their       
unsoundness arises from the fact that   
they reason from false premises2 and    
they get their false premises from their
 diseased imaginations1 whose vagaries  
they take for realities4  #b4 ,here a   

difficulty presents itself1 which we    
must explain at once1 namely1 how can   
there be unsoundness of mind at all8 ,is
 not the intellect of man a simple      
power1 and his soul a simple being8 ,how
 can a simple being become deranged8    
,can that which has no parts become     
disarranged1 disorganized8 ,i answer1   
the soul is a simple being1 its         
intellect is a spiritual faculty2 and   
therefore we never say that the soul is 
insane1 nor should we say that the      
intellect is insane or diseased2 but we 
say that the mind is deranged or insane2
 the mind comprises more than the       
intellect2 it designates the intellect  
together with those lower powers that   
supply the materials for our thought1   
the chief of which is the imagination4  
,now the imagination is an organic      
faculty3 it works in and by a bodily    
organism1 which is the brain4           
,therefore1 when the brain is not in a  
normal condition1 the action of the     
imagination may be disordered4 ,and the 

intellect or understanding of the       
spiritual soul is so closely united in  
its action and its very being with the  
organic body that the two ever act      
conjointly1 like the two wheels of a    
vehicle4 ,if one wheel breaks down1 the 
other is thrown out of gear4 ,thus it is
 readily understood that mental         
unsoundness is an affection of the      
brain1 a bodily disease1 which may often
 be relieved and even cured by bodily   
remedies1 by the use of drugs or        
wholesome food1 healthy exercise1 fresh 
air1 and all that benefits the nervous  
system4  ,pathologically considered1 the
 nerves may be too excited or too       
sluggish and torpid2 and we have as the 
result two subdivisions of mental       
insanity--mania and melancholia4 ,the   
differences between these two are very  
striking2 as they proceed from opposite 
causes they produce opposite effects1   
and1 therefore1 they betray themselves  
by very different manifestations2 but in
 one point the two agree1 and with this 

point precisely we are concerned1       
because in it lies the essence of mental
 insanity1 namely1 that both produce a  
disordered action of the imagination4   
#c4 ,the manner in which the imagination
 co-operates in mental action is this4  
,it presents to the intellect the       
materials from which that power forms   
its ideas4 ,when we see1 feel1 hear1    
taste1 or smell anything by our bodily  
senses1 our imagination takes note of   
the object perceived by forming a       
brain-picture of it which is called a   
phantasm4 ,i do not mean to say that it 
forms a photographic picture of the     
object2 for there can be no             
photographing taste or smell or feeling2
 but it forms an image of some kind     
which it presents to the intellect4     
,this power at once proceeds to form1   
not a brain-picture1 but an intellectual
 or abstract image of the object        
presented4 ,for instance1 you see this  
book1 and at once you1 in some          
mysterious way which has never yet been 

explained1 impress some image of it on  
your brain4 ,that you do so is clear    
from the fact that the image remains    
when the book is withdrawn4 ,that       
material image or brain-picture is the  
phantasm4 ,it is not an idea1 though it 
is often improperly so called4 ,but your
 intellect forms to itself an idea of a 
book2 that is1 you know what is meant by
 a book4 ,you distinguish between the   
mere form of a book and the book itself4
 ,your idea of a book is a universal    
idea1 which stands for any book1 no     
matter of what shape or size4 ,every    
phantasm1 or brain-picture1 is a        
representation which presents its object
 as having a definite shape or size1    
while your idea of a book ignores any   
shape or size4 ,and yet1 when your      
intellect conceives a book1 your        
imagination will picture some particular
 form of book4 ,if your brain became so 
affected by disease as to be unfit for  
the formation and retention of the      
proper phantasms1 then your intellect   

either would not work at all or it would
 work abnormally2 your mind would then  
be insane4  #d4 ,now1 in an infant the  
brain is still too soft and imperfect to
 form the proper phantasms from which   
the intellect is to elaborate its ideas4
 ,a false school of psychology would say
 that the infant's brain cannot yet     
ideate2 but that is incorrect language4 
,no brain can ideate or form ideas2 an  
idea is an intellectual or mind image1  
not a brain image2 it is an abstract and
 universal image1 and matter cannot     
represent but what is concrete and      
individual4 ,only a simple and spiritual
 being1 the rational soul1 can form     
ideas4 ,nevertheless our soul1 in its   
present state of substantial union with 
our body1 is extrinsically dependent on 
the body2 to form ideas it needs to have
 the sensible object presented to it by 
a phantasm or brain-picture4 ,now1 a    
child born blind and deaf1 and thus     
having its mind1 as it were1 cut off    
from communication with the outer world1

 could scarcely form the necessary      
phantasms1 because the clogged senses   
could not supply proper materials for   
them2 such a child would1 therefore1 be 
apt to remain idiotic4 ,and even in     
children whose outer senses are sound   
the brain or the nervous system may be  
too imperfect to allow of its forming   
proper phantasms4 ,in this torpor of the
 mind then consists the first kind of   
mental unsoundness1 that of idiocy1 or  
its milder form imbecility4 ,in old age1
 and in peculiar diseases1 the worn-out 
system may return to a second childhood1
 then called dementia or dotage4 ,the   
existence of such species of insanity is
 not difficult to discover4  #e4 ,the   
second and more common form of insanity1
 and that which it is often difficult to
 discover and pronounce upon with       
certainty1 is that which ,i have called 
delusional or illusional4 ,its          
characteristic trait1 its very essence1 
lies in this1 that the insane man       
mistakes what he imagines for what is   

real2 and he cannot be made to          
distinguish between imagination and     
reality1 though the difference is       
obvious to an intellect in its normal   
state4  ,in this connection1 it is well 
to point out a distinction1 not always  
observed1 but useful to explain the     
workings of an insane mind1 between     
illusions1 hallucinations1 and          
delusions4  7a7 ,an illusion is properly
 a deception arising from a mistake in  
sense-perception2 as when a half-drunken
 man sees two posts where there is only 
one4 ,he has a picture of the post in   
each eye1 and his brain is too much     
disturbed to refer the two pictures to  
the same object4 ,in this case the cause
 of the mistake is subjective4 ,a mirage
 offers another instance of a           
sense-illusion2 but in it the cause is  
objective4  7b7 ,a hallucination is a   
creation of the fancy mistaken for a    
reality4 ,the deception may be but      
momentary1 as when ,macbeth is stealing 
on tiptoe to the chamber of his guest to

 murder him4 ,his mind is disturbed by  
the imagination of the horrid deed he is
 about to perpetrate4 ,he thinks he sees
 a dagger in the air1 and he says3 ,is  
this a dagger that ,i see before me1 its
 handle towards my hand8 ,come1 let me  
clutch thee4 ,i hold thee not1 and yet  
,i see thee still2 and on thy dudgeon   
gouts of blood1 which was not so before4
 ,but ,macbeth1 upon a moment's         
reflection1 sees it is all imagination4 
,there's no such thing1 he exclaims4 ,he
 is not insane1 though deceived for a   
while4  7c7 ,a delusion1 on the         
contrary1 is a permanent deception1     
whether it results from an illusion or a
 hallucination1 it matters not2 as a    
fact1 it almost always originates in    
hallucinations4 ,the deluded man clings 
to his imaginings2 you cannot talk them 
out of his head4 ,such is the case of an
 inebriate who suffers from mania a     
potu1 or the horrors2 he sees snakes and
 demons1 he thinks1 and persists in his 
error4 ,such also is a fixed idea not   

arrived at by faulty reasoning1 but come
 unbidden and proof against all         
reasoning and evidence4 ,thus an insane 
man may be convinced1 solely by his     
imagination1 that he is poisoned or     
pursued or conspired against4  #f4 ,this
 delusion constitutes the essence of    
mental insanity1 which therefore is     
often called delusional insanity4 ,it   
may be chronic1 i4e41 of long           
continuance1 or it may be temporary1    
acute4 ,for the time being1 the effects 
are the same4 ,perhaps any man may1 at  
times1 be for a moment thrown off his   
guard1 and mistake a fancy for a        
reality2 this does not constitute       
lunacy4 ,but when the error is so firmly
 held in the mind's grasp that nothing  
can dislodge it thence1 then the mind is
 deranged in its special sphere of      
action1 which consists in knowing the   
real from the unreal2 the mind is then  
insane4  ,you notice1 gentlemen1 that ,i
 speak of the mind as grasping the      
error1 and ,i suppose it to do so       

independently of the free will's        
command4 ,but when the error is         
voluntary2 when a man clings to it      
simply because he loves it2 when he hugs
 a delusion to his heart1 this shows not
 mental but moral obliquity2 it is not  
insanity but self-deception1 and it is  
by no means of rare occurrence4 ,in a   
well-reasoned article on ,the           
,metaphysics of ,insanity1 written by   
,mr4 ,james ,m4 ,wilcox and printed in  
the ,american ,catholic ,quarterly      
,review for ,january1 #ahgh1 some very  
severe and no less true strictures are  
made upon the readiness of a vast       
multitude of people to practise this    
wilful self-deception4 ,self1 he writes 
7p4 #ed71 is the prolific origin of such
 errors2 and so indulgent are we to its 
faults that we try secretly to hide them
 even from our own eyes1 mostly with    
success2 and where success is not       
perfect1 we make a second effort to hide
 the imperfection4 ,repeated efforts of 
this kind1 from which we but half turn  

away1 are crowned in the end1 and we    
soon forget what successful hypocrites  
we have been4 ,our numerous passions1   
the complexities of our desires1 the    
tenacity of their grasp1 and the        
pleasant gentleness of its touch explain
 an infinity of temptations followed by 
wilful successes in blindness1 all of   
which are nothing less than guilty acts 
of self-deception4  #g4 ,it oftens      
happens in real insanity that mental    
derangement manifests itself upon one   
error or one group of errors only1 while
 for all the rest the patient appears to
 be quite rational4 ,such a man is      
called a monomaniac4 ,but he is truly an
 insane man2 for the essence of insanity
 is in him4 ,it is usually found that a 
monomaniac will1 sooner or later1       
exhibit signs of mental unsoundness on  
other matters as well2 and even while he
 has given no such signs1 it still      
remains true that a mind cannot be      
trusted1 but has something radically    
unsound about it1 if it is really       

unhinged at any point at all4  ,but then
 you must be very careful not to        
confound monomania with eccentricity4   
,the distinction is as important as it  
is real4 ,eccentricity is a conscious   
aberration from the common course of    
life2 it consists in peculiarities in   
reasoning1 words1 and actions1 which are
 wilfully indulged1 in defiance of      
popular sentiment4 ,the eccentric man   
knows that he is eccentric2 he is       
willing to be so1 and to take the       
consequences2 but he is not insane4  ,as
 this matter is of frequent occurrence  
before the courts of justice1 and the   
validity of last wills in particular    
often depends on the view that judges   
and expert witnesses take of it1 ,i     
think it well to refer the earnest      
student for further information to      
,wharton's and ,still's ,medical        
,jurisprudence1 in the volume on ,mental
 ,unsoundness and ,psychological ,law2  
in particular to secs4 #bi1 #ch1 #ci1   
#dj4  #h4 ,we must now return to the    

consideration of the manner in which the
 disturbance of the brain may affect the
 mind4 ,the brain is a storehouse of    
records of things formerly noted there  
by the imagination1 either as the       
results of sense perception or of       
arbitrary combinations of phantasms2 it 
is a library of facts and fancies4 ,and 
these are not single1 but grouped       
together1 so that when one is stirred it
 will arouse others as well4 ,when the  
brain is affected1 whether by an acute  
or a chronic derangement1 its images may
 become so disordered that records of   
mere imaginations get mixed up with     
records of real perceptions in          
inextricable confusion4 ,you may have   
had occasion to notice the process in   
the case of a man who is becoming       
intoxicated and then passes on to mania 
or delirium tremens3 he gradually       
proceeds to mix up brain-pictures with  
realities1 and after a while he speaks  
and acts like a very crazy man4 ,he is  
in a kind of dream2 his imaginations are

 wild and disconnected1 his language is 
incoherent4  ,the delirium arising from 
violent fevers1 for instance from       
typhoid fever1 is very similar to that  
arising from the excessive use of       
intoxicants and narcotics2 similar in   
these respects2 that the mania is only  
temporary1 and that the exciting cause  
is not altogether unknown4  ,the bacilli
 of the infection1 like the alcohol1 the
 opium1 the morphine1 or other drugs1   
are accountable for the disordered      
action of the brain4 ,but ,i do not     
pretend to know1 nor do medical writers 
generally pretend to understand1 how the
 poison1 or whatever causes the disease1
 gets to affect the brain4 ,does it do  
so directly1 or by means of the         
alteration it causes in the whole       
nervous system or in the blood8 ,we do  
not know2 nor does it matter for the    
purposes of ,medical ,jurisprudence4    
,,iv4 ,the questions with which the     
courts of justice1 the lawyers1 and the 
expert witnesses are concerned are      

these3 ,is the man really insane8 ,or   
was he insane at a given time when he   
performed a certain civil or criminal   
act8 ,is he now1 or was he then1 so far 
controlled by his mental unsoundness as 
to be incapable of acting like a        
rational being accountable for his      
actions8 ,even if he is now1 or was     
then1 a monomaniac1 can the deed in     
question be traceable to his monomania  
as to its real cause8  #a4 ,when we know
 that a man is suffering from a fever1  
or has been drinking to excess1 or has  
been addicted to the use of morphine1   
opium1 cocaine or to similar deplorable 
practices1 it is then easy enough to    
conclude from this that he is not in his
 right senses2 knowing the cause1 we can
 fairly estimate the effect4 ,but in    
many cases of delusional insanity the   
cause is hidden2 neither pulse nor other
 medical test betrays it4 ,whether the  
mind is sane or not is then to be found 
out from the man's words and actions2   
and these may be affected for a purpose3

 he may play the fool to escape         
punishment4  #b4 ,phrenologists have    
pretended that the peculiarities of a   
person's mind could be known by the     
conformation of his brain1 and even by  
the elevations and depressions of the   
skull4 ,but brain and skull do not      
always correspond with sufficient       
closeness2 and besides1 ,sir ,william   
,hamilton has shown conclusively1 ,i    
believe1 that phrenology is quackery2   
its principles are not scientific and   
its observations not reliable4 ,he      
points out1 among other errors1 that    
while women as a class are more         
religiously inclined than men1 what     
phrenologists call the bump of          
reverence1 an important element in      
religious sentiment1 is generally more  
developed in men than in women1 and is  
often most conspicuous in reckless      
criminals4  ,nor is it at all certain   
that a lunatic's brain1 if it could be  
examined with a microscope while he is  
alive1 would exhibit the marks of any   

disorder to the eye of the observer4 ,it
 is stated by ,dr4 ,storer that the     
results show that insanity may exist    
without structural changes of the brain1
 and that structural changes in the     
brain may exist without insanity4 ,dr4  
,bell1 of the ,somerville ,asylum1 says 
that the autopsies of the insane        
generally present no lesion of the      
brain4 ,dr4 ,bucknil maintains that the 
brains of the insane appear to be       
certainly not more liable than those of 
others to various incidental affections4
 ,nor has the microscope discovered in  
the demented any exudation or addition  
to the stroma of the brain1 or any      
change in size1 shape1 or proportional  
number of its cells4 ,dr4 ,storer       
concludes3 ,it is thus seen not merely  
that there is no direct correspondence  
between the exterior of the skull and   
mental integrity1 any more than between 
the exterior of the skull and the shape 
and consistence of its contents         
7,wharton and ,still1 ,mental           

,unsoundness1 sec4 #cbc74 ,in the cases 
of insanity among women1 the causes are 
largely to be found in derangement of   
their productive organs1 and are to be  
met by special local treatment 7ib474   
,it does happen1 however1 at times1 that
 the brain itself is diseased1          
idiopathically diseased1 as it is       
technically called2 but at other times  
it is merely affected by sympathy with  
some other organ that is physically     
deranged4 ,a physical cause there is for
 all mental insanity1 and that physical 
cause determines its kind of mania or   
melancholia1 its duration1 its chances  
of a perfect cure4 ,but what that cause 
is in a given case is often very hard if
 not impossible to determine4 ,besides  
natural and inherited                   
predispositions--some taint of          
derangement in the family1 often        
betrayed by fits of epilepsy1 hysterics1
 etc4--exciting causes are usually      
traceable4 ,every form of disease may   
bring on sympathetic affection of the   

brain when the circumstances for such   
affection are favorable4  ,but while    
affirming that the disease usually      
arises in the body1 and even frequently 
in parts far removed from the brain1 we 
must not deny nor ignore the fact that  
intellectual and protracted worry1 or   
sudden and violent grief1 can also be   
the direct cause of disturbance in the  
brain4 ,for the brain is the organ not  
of the imagination alone1 which is put  
to an unhealthy strain by excessive     
mental labor1 but probably also of the  
passions1 whose emotions when excessive 
may cause even permanent lesion4 ,hence 
mental insanity may and does often arise
 from ill-subdued passions4  ,the       
knowledge of all this may enable the    
physician to remove the exciting cause  
or to mitigate its influence2 it may    
also aid expert witnesses1 judges1      
lawyers1 and jurymen to ascertain the   
main fact with which the courts are     
concerned1 namely1 the presence or      
absence of mental insanity at the time  

of a given civil or criminal action4    
,v4 ,supposing then that1 in the case   
before the court1 the fact of insanity  
is established1 the next question of    
,jurisprudence to determine is this3    
,how far and why ought such unsoundness 
of mind to exclude responsibility for   
deliberate acts8  ,it is a clear        
principle of reason that no man can     
justly be blamed or punished for doing  
what he cannot help doing2 now an insane
 man cannot help judging wrong at times2
 he cannot then justly be blamed for    
acting on his mistaken judgments4 ,if he
 invincibly judges an act to be morally 
good whereas it is morally bad1 no      
matter how criminal the act may be--say 
the killing of his own father or        
child--if he commits the deed with the  
full conviction that he is doing right1 
he cannot be blamed or punished for     
committing that awful crime4  ,the      
principle then is clear that an insane  
man is not to be held responsible to    
,god or man for his insane acts4 ,for   

the root and reason of our              
responsibility for an act lies in the   
fact that we do the deed of our own free
 choice2 knowing its moral nature1 being
 masters of our own free will1 so that1 
if we do one act in preference to       
another1 we wilfully take upon ourselves
 the consequences of this preference as 
far as we can know or suspect them4  ,if
 we do what we are firmly convinced is  
right1 just1 worthy of a man1 we deserve
 praise2 if we do what we are convinced 
or suspect is wrong1 unjust1 unworthy of
 a man1 we deserve blame and punishment4
 ,but an insane man may do the most     
unjust act1 and yet feel invincibly     
convinced that it is just2 he cannot    
then be held responsible for doing it1  
because the root of responsibility is   
then wanting4  ,i do not1 however1      
maintain that one who is insane on any  
one point is thereby made irresponsible 
for all his actions4 ,if he does what he
 thinks to be wrong1 he acts against the
 dictates of his conscience1 he deserves

 punishment from ,god2 and if he        
violates a just law of the land1 and it 
can be proved that his deed proceeded   
from a bad will1 he may be punished by  
the civil courts as well1 even though he
 is insane on other points4 ,for        
instance1 if a young man were to have a 
crazy notion that his father disliked   
him1 that he is often in various ways   
unjust to him1 and if1 in consequence of
 this insane conviction1 he were to     
attempt his father's life1 he should be 
punished for the criminal act2 because1 
even according to the way he views the  
matter1 he could not be justified in    
killing his father for such a reason4   
,it were different if he insanely       
imagined that his father was in the act 
of killing him1 and that he could not   
escape death but by killing his father  
first2 for then he could plead the right
 of self-defence against an unjust      
aggressor1 as he foolishly imagines his 
father to be4  ,the conclusion then from
 all this explanation is that an insane 

man should not be held responsible for a
 deed which he insanely thinks to be    
right2 but he is responsible for all his
 other acts4  ,in our next lecture we   
shall consider more fully the treatment 
of the insane by the civil and criminal 
tribunals4     ,,lecture ,,viii4  ,,the 
,,legal ,,aspects ,,of ,,insanity4   ,in
 our last lecture1 gentlemen1 we        
considered the nature and causes of     
delusional insanity4 ,we saw that its   
essence lies in mistaking imaginations  
for realities with a firmness of        
conviction which no argument to the     
contrary can shake4 ,the reasoning of   
the insane man may be logically         
faultless1 we said1 but he reasons from 
false premises supplied to him by the   
phantasms of a diseased imagination4    
,the cause of the disease ,i showed to  
lie in an abnormal action of the brain1 
which is the storehouse of the phantasms
 or brain-pictures4 ,and this abnormal  
action may itself proceed either from a 
local lesion of the brain1 or from a    

sympathetic affection due to            
indisposition in other parts of the     
human body4 ,i finished by examining the
 responsibility of an insane man for his
 actions1 and arrived at this practical 
conclusion1 that a victim of delusional 
insanity should not be held responsible 
for any acts which he insanely thinks   
right1 but should be held responsible   
for all his other human acts4  ,i4 ,this
 teaching of psychological and ethical  
science is to-day the received rule of  
action followed by the courts of justice
 in ,england and the ,united ,states4   
,sound philosophy and positive law are  
in perfect agreement on this subject4   
,but it was not so a hundred years ago4 
,it is wonderful to us now how strange  
and erroneous were the views of insanity
 formerly entertained by ,english       
jurists4 ,for instance1 when1 in #agbc1 
,arnold was tried for shooting at ,lord 
,onslow1 the instruction given to the   
court was that1 for one to be exempt    
from punishment in such a case1 it must 

be a man that is totally deprived of his
 understanding and does not know what he
 is doing1 no more than an infant1 than 
a brute or a wild beast4 ,on such a     
theory1 very few lunatics indeed would  
be acquitted2 few ever are so totally   
demented4  ,the first jurist that       
pointed out the true test of insanity   
was ,lord ,erskine1 who1 in #ahjj1 when 
,hudfield was tried for shooting at the 
king1 delivered a celebrated speech1 in 
which he maintained that the real test  
of insanity was in delusion3 if delusion
 existed the man was insane2 else1 he   
was not insane4 ,the deluded man1 he    
said1 might reason with admirable logic 
from his false principles2 he was       
nevertheless demented if he mistook his 
imaginations for realities1 and did so  
irresistibly and persistently4          
,erskine's test has been1 from that time
 on1 followed in the courts of ,england4
 ,but you will notice1 on careful       
consideration1 gentlemen1 that while the
 principle is correct so far as it goes1

 it does not go far enough to cover all 
cases of disputed responsibility4 ,it   
will apply1 indeed1 to all cases of     
total insanity1 that is1 when the       
delusion existing in a lunatic's mind   
affects a variety of subjects2 then his 
premises are never reliable1 and        
therefore he cannot be held accountable 
for any of his acts4  ,but what if his  
insanity is partial only1 if he is a    
monomaniac1 deranged on one point and   
sound in mind on all other matters8     
,this was not clearly understood till   
about the middle of the present century4
 ,in order to secure uniform views and  
action on this important matter1 the    
,british ,parliament1 in #ahdc1 proposed
 various questions to the judges1 with a
 request that they would agree upon and 
report answers4 ,this investigation1 and
 in fact the whole history of ,english  
legislation on insanity1 is briefly and 
yet clearly explained in an article of  
,rev4 ,walter ,hill1 ,s4,j41 which      
appeared in the ,american ,catholic     

,quarterly ,review for ,january1 #ahhj4 
,the first question was3 ,what was the  
law respecting the crime of one who is  
partially deluded but not insane in     
other respects1 when he commits what he 
knows to be a crime in order to redress 
some wrong or obtain some public        
benefit8 ,the answer was that such a    
one1 even though insane1 is to be       
punished for the crime which he knew he 
was committing4  ,to another of those   
questions the judges answered1 that a   
person partially insane was to be       
treated as if the facts were just what  
he imagined them to be1 as if his       
delusions were realities4 ,his conduct  
was to be judged by his own premises4   
,this was accepted as law by ,england1  
and is the law now both there and here1 
and1 ,i suppose1 throughout the         
civilized world4 ,now1 these are exactly
 the conclusions about an insane man's  
responsibility which we had arrived at  
before1 reasoning from psychological and
 ethical first principles4  ,it is      

therefore for the consequences of an    
insane delusion only that a man is not  
responsible before the inward court of  
conscience and the outward courts of    
justice4  ,but the case is altogether   
different when the error is not the     
result of insane delusion4 ,when a man1 
sane or partially insane1 has reasoned  
himself into a false opinion or         
conviction1 not the result of his       
insanity1 that the crime he is going to 
commit is justifiable1 such conviction  
being his own free act does not exempt  
him from punishment4 ,this was the      
precise point on which turned the       
celebrated case of ,guiteau1 the        
murderer of ,president ,garfield4 ,his  
trial before the ,supreme ,court1       
,district of ,columbia1 ,december1      
#ahhb1 was one of the most interesting  
that have ever occurred in this country 
or elsewhere in connection with the plea
 of insanity4 ,in his very able and     
exhaustive instructions to the jury on  
that occasion1 ,judge ,cox states the   

rule that is to guide the jury in these 
words3 ,it has been argued with great   
force on the part of the defendant that 
there are a great many things in his    
conduct which could never be expected of
 a sane man1 and which are only         
explainable on the theory of insanity4  
,the very extravagance of his           
expectations in connection with this    
deed--that he would be protected by the 
men he was to benefit1 would be         
applauded by the whole country when his 
motives were made known--has been dwelt 
upon as the strongest evidence of       
unsoundness4 ,whether this and other    
strange things in his career are really 
indicative of partial insanity1 or can  
be accounted for by ignorance of men1   
exaggerated egotism1 or perverted moral 
sense1 might be a question of           
difficulty4 ,and difficulties of this   
kind you might find very perplexing if  
you were compelled to determine the     
question of insanity generally1 without 
any rule for your guidance4  ,but the   

only safe rule for you is to direct your
 reflections to the one question which  
is the test of criminal responsibility1 
and which has been so often repeated to 
you1 viz41 whether1 whatever may have   
been the prisoner's singularities and   
eccentricities1 he possessed the mental 
capacity1 at the time the act was       
committed1 to know that it was wrong1 or
 was deprived of that capacity by mental
 disease4  ,what furnished the clearest 
proof1 gentlemen1 that ,guiteau's       
opinion concerning the expediency of    
killing the ,president resulted not from
 an insane delusion but from his own    
reasoning is contained in a paper which 
he had himself drawn up to justify the  
murder4  ,it is an address to the       
,american people1 published on ,june    
#af1 in which he says3 ,i conceived the 
idea of removing the ,president four    
weeks ago2 not a soul knew my purpose4  
,i conceived the idea myself and kept it
 to myself4 ,i read the newspapers      
carefully1 for and against the          

,administration1 and gradually the      
conviction dawned on me that the        
,president's removal was a political    
necessity1 because he proved a traitor  
to the men that made him1 and thereby   
imperilled the life of the ,republic4   
,again he says3 ,ingratitude is the     
basest of crimes4 ,that the ,president  
under the manipulation of the ,secretary
 of ,state has been guilty of the basest
 ingratitude to the ,stalwarts1 admits  
of no denial4 ,the express purpose of   
the ,president has been to crush        
,senator ,grant and ,senator ,conkling1 
and thereby open the way for his        
renomination in #ahhd4 ,in the          
,president's madness he has wrecked the 
once grand old ,republican ,party1 and  
for this he dies4--,this is not murder4 
,it is a political necessity4 ,it will  
make my friend1 ,arthur1 ,president1 and
 save the ,republic1 etc4  ,when        
instructing the jury1 ,judge ,cox told  
them clearly that1 if they found1 from  
all the testimony presented1 that the   

culprit had been led to commit the      
murder by an insane delusion1 they were 
to acquit him2 but that reasoning one's 
self into an opinion or conviction was  
not acting upon an insane delusion4     
,when men reason1 he said1 the law      
requires them to reason correctly1 as   
far as their practical duties are       
concerned4 ,when they have the capacity 
to distinguish between right and wrong1 
they are bound to do it4 ,opinions1     
properly so called1 that is1 beliefs    
resulting from reasoning1 reflection1 or
 examination of evidence1 afford no     
protection against the penal            
consequences of crime4 ,on this precise 
point of the question then the verdict  
was to depend4  ,but to understand this 
matter thoroughly there remains one more
 important point to notice in the       
instructions of ,judge ,cox4 ,it relates
 to the question on whom rests the      
burden of proof regarding the existence 
of insanity in the culprit4 ,is the     
prosecution bound to prove that insanity

 did not influence the crime8 ,or is the
 defence to prove that it did8 ,and1 in 
case neither party can prove its point  
to a certainty1 so that the jury remains
 in doubt as to the existence or the    
influence of insanity in the crime1 is  
the doubt to weigh in favor of the      
culprit or against him8 ,the judge1     
after a careful exposition of the       
conflicting views on this subject by    
different courts1 and after weighing    
their respective claims1 favors the     
opinion which holds that the sanity of  
the accused is just as much a part of   
the case of the prosecution as the      
homicide itself1 and just as much an    
element in the crime of murder1 the only
 difference being that1 as the law      
presumes every one to be sane1 it is not
 necessary for the government to produce
 affirmative proof of the sanity2 but   
that1 if the jury have a reasonable     
doubt of the sanity1 they are just as   
much bound to acquit as if they         
entertain a reasonable doubt of the     

commission of the homicide by the       
accused4  ,but the jury1 enlightened by 
the lucid instructions of the court1    
were convinced that ,guiteau had not    
been led to commit the murder by an     
insane delusion1 but by his own         
reasoning and his own free will1 and    
that1 therefore1 he was to bear the     
consequences of his own deliberate      
choice4 ,their verdict was guilty1 and  
the political crank was hanged4  ,,ii4  
,we have now done with the study of     
mental or delusional insanity2 it       
remains for us to speak of moral        
insanity4 ,of late years1 the legal and 
medical professions have been much      
divided upon the question whether there 
exists a disease which may properly be  
called moral1 emotional1 or affective   
insanity1 and which can justly be       
pleaded as an excuse from legal         
responsibility4  ,dr4 ,pritchard1 and   
later on1 ,dr4 ,maudsley1 with very many
 followers1 have maintained the         
existence of such a disease1 and have   

claimed that1 even when it is not       
accompanied by any delusion1 it ought1  
nevertheless1 to free a man from all    
punishment for crimes committed under   
its influence4 ,moral insanity consists1
 they say1 in a perversion of the will1 
which by this disease is deprived of its
 liberty1 so that the morally insane man
 does what he knows to be wrong1 but    
cannot help doing it4 ,and they claim   
that therefore he cannot be blamed nor  
punished for the crime he thus commits1 
although he commits it knowingly and    
willingly4  ,but ,i absolutely deny that
 such a state of insanity is possible4  
,it is against those clear principles of
 psychology and ethics which are not    
only speculatively evident1 but         
practically necessary to maintain the   
fabric of human society4 ,i do not deny 
that there exists an emotional insanity 
of another kind1 which ,i will explain  
further on1 but not an insanity of the  
will1 as they understand it1 which would
 excuse a man from the consequences of  

his wilful acts4 ,upon this subject ,dr4
 ,chipley justly remarks3 ,if one is    
born with all the emotional endowments  
of our nature1 but destitute of         
understanding1 his irresponsibility is  
unquestionable4 ,the same is true when  
the faculties of the understanding are  
perverted1 impaired1 or destroyed by    
disease4  ,in every aspect in which     
man's accountability is viewed1 we      
arrive at the same point that its sole  
basis is the existence and soundness of 
the intellectual powers4 ,those         
wonderful endowments which so eminently 
distinguish man from other animals1     
which enable him to discriminate between
 good and evil1 right and wrong1 and to 
choose the one and avoid the other2 or  
in the language of ,judge ,robertson1 he
 is accountable because he has the light
 of reason 'to guide him in the pathway 
of duty1 and a free and rational        
presiding will to enable him to keep    
that way in defiance of all passion and 
temptation4'  ,if then accountability is

 a structure erected solely on the      
intellectual power1 must it not remain  
unshaken so long as its foundation is   
sound and unbroken8 ,is it not illogical
 to set out with the fundamental        
proposition1 that man is made           
responsible for his acts only because he
 is gifted with an understanding and    
then arrive at the conclusion that he   
may become irresponsible without the    
impairment or disease of any of its     
powers8 7,wharton and ,still1 ,mental   
,unsoundness1 p4 #agj47  ,gentlemen1 let
 me give you a specimen of the false    
reasoning used in support of their      
theory by those who believe in the      
insanity of the will4 ,it would be as   
rational1 says one of their leading     
writers in this country1 to punish a    
schoolboy whose antics and grimaces1 the
 result of chorea ,st4 ,vitus' dance1   
are a source of laughter and distraction
 to his schoolmates1 as to inflict      
punishment upon the insane criminal who1
 knowing the difference between right   

and wrong1 has it not in his power to   
execute that which his judgment         
dictates4 ,one is under the dominant    
influence of insanity of the muscles1   
the other is under the influence of     
insanity of the will4 ,to punish one    
would be as cruel as to punish the      
other4 ,this is indeed a very illogical 
argument4 ,the reason why we do not     
blame the boy is because his will is not
 in it2 he moves against his will4 ,the 
reason why we blame the other is because
 his will is in it2 he does what he     
wills to do4  ,the will being a         
spiritual power can no more be diseased 
than can the intellect4 ,but as the     
imagination1 an organic power1 can be   
disorganized by an affection of the     
brain1 and by delusion deceive the      
intellect1 thus producing mental        
insanity1 similarly ,i fully admit that 
a man's passions1 which are also organic
 powers1 common to us and to brute      
animals1 can become disordered by bodily
 disease2 and the passions1 when        

excited1 will strive to drag along the  
consent of the will1 as we all          
experience4 ,a man whose passions are   
abnormally influenced by bodily disease1
 so that he is constantly inclined to   
act very unreasonably1 may well be      
called morally insane4 ,such a state of 
insanity is not a rare occurrence1 and  
there is no objection to denominate it  
emotional1 affective1 or moral insanity4
  ,but in such a disease the will       
remains free2 if a man does what he     
knows to be wrong and criminal1 he then 
sees reasons for not doing it2 and in   
this lies the root of his liberty4 ,for 
seeing himself drawn in one direction by
 one motive and in another by another   
motive1 he is not determined in his     
choice but by the act of his free will4 
,a merely organic faculty must be       
determined by the stronger attraction1  
as is the case with brutes2 but a       
spiritual faculty1 as our will is1 acts 
freely in choosing between two opposing 
motives of action4 ,this is the         

philosophical or psychological          
explanation3 and ,i am well pleased to  
find that here again1 as in the matter  
of mental insanity1 the courts of       
,england and the leading courts of the  
,united ,states follow the sound        
teachings of philosophy4  ,the nearest  
advance ,i know of1 that has been made  
towards the recognition of this moral   
insanity as a total bar to              
responsibility1 was made in #ahfd by the
 court of appeals in ,kentucky1 and     
again in #ahfi under the same presiding 
,judge ,robertson4 ,but ,chief ,justice 
,williams rebukes this strange ruling in
 most emphatic language4 ,he says3 ,in  
all the vague1 uncertain1 intangible1   
and undefined theories of the most      
impractical metaphysician in psychology 
or moral insanity1 no court of last     
resort in ,england or ,america1 so far  
as has been brought to our knowledge1   
ever before announced such a startling1 
irresponsible1 and dangerous proposition
 of law1 as that laid down in the       

inferior court4 ,for1 if this be law1   
then no longer is there any             
responsibility for homicide1 unless it  
be perpetrated in calm1 cool1           
considerate condition of mind4  ,what is
 this proposition if compressed into a  
single sentence8 that1 if his intellect 
was unimpaired and he knew it was       
forbidden both by human and moral laws2 
yet if at the instant of the act his    
will was subordinated by any            
uncontrollable passion or emotion       
causing him to do the act1 it was moral 
insanity1 and they ought to find for the
 plaintiff8444 ,if so1 then the more    
violent the passion and desperate the   
deed1 the more secure from punishment   
will be the perpetrator of homicide or  
other crimes4444 ,the doctrine of moral 
insanity1 ever dangerous as it is to the
 citizen's life1 and pregnant as it is  
with evils to society1 has but little or
 no application to this case4 ,too      
uncertain and intangible for the        
practical consideration of juries1 and  

unsafe in the hands of even the most    
learned and astute jurist1 it should    
never be resorted to for exemption from 
responsibility save on the most         
irrefragable evidence1 developing       
unquestionable testimony of that morbid 
or diseased condition of the affections 
or passions1 so as to control and       
overpower or subordinate the will before
 the act complained of 7ib41 p4 #agb74  
,you will notice1 gentlemen1 that ,chief
 ,justice ,williams does not deny the   
existence of every kind of moral        
insanity4 ,as ,i explained before1 not  
the will but the passions may really be 
diseased or insane1 and they may prompt 
the lunatic to commit very unreasonable 
and even criminal acts4 ,when the       
impulse of a passion is violent1 so that
 a man is carried along by it before he 
has had time to reflect on the criminal 
nature of his act1 or at least before he
 could do so calmly and deliberately1   
the courts readily recognize such       
passion as a partial excuse3 murder thus

 committed in a moment of strong        
provocation becomes manslaughter1 not   
murder in the proper sense of the word4 
,it is not justifiable2 but yet it is   
far less criminal and less severely     
punished than when committed in cold    
blood1 or1 as the law terms it1 with    
malice prepense or aforethought4 ,this  
practice of our courts is right and     
highly reasonable1 because on such      
occasions the will of the culprit is    
partly overpowered1 or deprived of      
freedom4  ,it is a matter of much       
discussion among jurists whether a      
passion can ever be so violent as to    
overpower the will absolutely1 so as to 
deprive it of all freedom at the moment4
 ,if it can1 then the culprit should be 
totally acquitted for doing what he     
could not help doing4 ,in several       
,states of the ,union1 such an          
invincible impulse has been recognized  
by the courts of justice1 and men have  
been acquitted for acting on what was   
supposed to be an invincible impulse to 

commit crime2 the courts considered this
 as an extreme form of moral insanity4  
,i have shown above that on sound       
principles of philosophy the will can   
never be compelled to do wrong2 at most 
it could be said that1 in the cases just
 referred to1 the will was not in the   
act4 ,now this1 ,i suppose1 is the case 
in hydrophobia or rabies1 in which      
terrible disease the biting of the      
sufferer appears to be spasmodic1 not   
voluntary4 ,it is very doubtful whether 
such excuse can be substantiated in what
 is called moral insanity4  ,the courts 
of ,england and the leading authorities 
in the ,united ,states have never       
departed from this correct rule1 that a 
man is accountable1 to some extent at   
least1 for whatever he does willingly   
and without the influence of delusion4  
,moral insanity thus understood1 as a   
derangement of the passions lessening a 
man's full mastery of himself1 but not  
destroying it altogether1 assumes       
various forms4 ,there are kleptomania1  

or an abnormal impulse to steal2        
pyromania1 an impulse to set things on  
fire2 dipsomania1 or an abnormal        
fondness for intoxicants2 nymphomania1  
or the tyranny of lustful passions2     
homicidal mania1 or a craving to commit 
murder2 etc4 ,in all these the nature of
 the disease is the same1 it would      
appear4 ,the imagination seizes the     
pleasure vividly1 yet1 it is claimed1   
without delusion3 and the passion1 owing
 to organic disorder1 is abnormally     
excitable4 ,the organic derangement is  
supposed to be in the brain4 ,for the   
human brain1 a masterpiece of the       
,creator's wisdom1 is now generally     
believed to consist of various portions 
which are the organs of the passions1 of
 motive power and the phantasms1        
erroneously called ideation4 ,hence it  
is easy to understand how it may happen 
that one portion is diseased while the  
other parts are in a normal condition4  
,and on the other hand it thus appears  
very probable also that a brain         

partially diseased is liable to be soon 
affected in the other parts as well4    
,hence we may suspect that moral        
insanity is likely to bring on          
delusional insanity1 and vice versa4 ,in
 fact1 ,i find that a medical expert of 
note1 who had for many years taught that
 moral insanity was quite a distinct    
disease and separate from mental        
insanity1 has in his old age changed his
 mind to some extent on this subject4   
,of late years1 says ,dr4 ,bauduy1 of   
,st4 ,louis1 in his learned work on     
,diseases of the ,nervous ,system1 ,i   
have believed1 notwithstanding the      
doctrine of ,pritchard1 that a careful  
study of moral insanity will enable us  
to detect some evidence1 although1 it   
must be confessed1 often very feeble1 of
 mental weakening4 ,even the classic    
cases of ,pritchard1 he adds1 who first 
defined the so-called moral insanity1   
when carefully examined1 will confirm   
this statement 7p4 #bbg74 ,usually1 as  
the same ,dr4 ,bauduy explains1 those   

who are morally insane are at least on  
the high road to mental insanity 7p4    
#bbh74 ,moral insanity is known to exist
 when there is a sudden change of       
character which can have no other source
 than bodily disease2 as when a most    
honest man becomes of a sudden an       
habitual thief1 a decent man openly     
profane1 a miser becomes extravagantly  
liberal1 an affectionate father a very  
tyrant to his children1 without any     
traceable causes for such               
transformation4 ,the disease is made    
more manifest if such a sudden change is
 preceded by certain physical           
conditions1 such as epilepsy1 hereditary
 taint1 suicidal attempts1 the insane   
temperament1 as it is called1 and other 
influences which are to be taken into   
consideration4  ,if ever you be         
summoned1 gentlemen1 to testify or      
pronounce on a person's insane          
condition1 let me give you one piece of 
advice which may spare you much         
unpleasantness3 be unusually cautious of

 what you say4 ,if you appear as an     
expert or a witness1 and you make a     
mistake unfavorable to the patient1 he  
will be your enemy for life2 even he may
 at times recover damages for libel4 ,if
 he is really crazy1 he may be all the  
more dangerous4 ,do your duty1 of       
course1 as an honest man must always do2
 but do it very prudently4  ,dr4 ,bauduy
 is very emphatic on the assertion that 
moral insanity is not moral depravity4  
,he is perfectly right2 yet we must not 
forget that moral depravity is often    
screened before the courts by the plea  
of insanity4 ,when a man of bad         
antecedents commits a crime1 and is     
known to have been sane just before and 
after the deed1 he ought not to be      
excused on the plea that he may have    
been insane at the moment when he       
committed the act2 there is no reason   
for such a plea4 ,and with the victims  
of kleptomania1 dipsomania1 and other   
moral manias1 it is well known that a   
sound whipping will often stop the      

nuisance4 ,the rod for the juvenile     
offender1 and the whipping-post for     
adults1 would cure many a moral leper   
and be a strong protection for society  
at large1 especially if applied before  
bad habits freely indulged have         
demoralized the person beyond the usual 
limits4 ,all of us have our passions2   
they are an essential part of our nature
 and even an indispensable part4 ,but   
they should be controlled by reason and 
will1 whereas they are often indulged   
with guilty weakness4 ,they are much    
strengthened by indulgence1 especially  
in those predisposed to certain vices by
 hereditary transmission4 ,no doubt some
 children have worse passions to contend
 against than others4 ,it is still worse
 if1 at the same time1 their            
surroundings are unfavorable to virtue2 
and this is a constant source of        
increase to the criminal classes4  ,wise
 statesmen will study the ways in which 
temptations to vice may be diminished2  
but it is mistaken mercy and dangerous  

to the community to spare the guilty    
when once they have committed criminal  
acts4 ,if ever the principle were       
admitted in our courts of justice that  
the possible existence of mental        
insanity ought to protect a culprit from
 punishment1 crime would soon increase  
tenfold both in the sane and in the     
insane4 ,both classes must be kept      
impressed with the conviction that the  
law rules supreme and will not tolerate 
the destruction of public safety4 ,your 
profession1 gentlemen1 in this matter as
 in many others1 by its sound views on  
,jurisprudence and ,ethics1 is one of   
the strongest bulwarks of the common    
good4     ,,lecture ,,ix4  ,,hypnotism  
,,and ,,the ,,border-,,land ,,of        
,,science4   ,in this last lecture of   
our course ,i propose to make a brief   
excursion with you into the border-land 
of science1 a region chiefly occupied by
 imposture and superstition4 ,to show   
there is such a territory1 we have only 
to name a few of its inhabitants1 such  

as mesmerism1 animal magnetism1 odylism1
 hypnotism1 mind-reading1 faith-cures1  
clairvoyance1 spiritism1 including      
table-rapping1 spirit-rapping1 most of  
which have been used in connection with 
medicine4 ,i do not maintain that all of
 these are mere vagaries1 empty shadows1
 without the least reality1 mere ghosts 
and hobgoblins1 mere phantoms of the    
heat-oppressed brain1 or cunning devices
 of impostors to deceive a gullible     
crowd of the ignorant public4 ,yet most 
of these are such beyond a doubt1 and as
 such are totally unworthy of our       
attention4  ,medicine is a science2 it  
deals with undoubted facts and certain  
principles1 and with theories in so far 
as they are supported by                
well-ascertained realities4 ,the        
border-land of which ,i speak presents  
to our investigation few certain facts4 
,it is chiefly the domain of imposture4 
,charlatans and showmen and medical     
quacks call things facts that are not   
facts4 ,among all the inhabitants of the

 shadowy region that ,i have enumerated1
 there is only one considered to-day by 
the science of medicine as worthy of its
 attention4 ,it is hypnotism4 ,as its   
first origin is connected with the      
history of mesmerism1 and the latter1   
though itself a phantom1 has been used  
as the chief patron of all other        
phantoms1 ,i will premise a few words   
about mesmerism itself4  ,i4 ,mesmer was
 born about #agcc1 studied in ,vienna   
and there became a doctor of medicine in
 #agff4 ,soon after1 he began to        
speculate upon the curative powers of   
the magnet1 and claimed to have         
discovered the existence of a force in  
man similar to magnetism and the source 
of strong influence on the human body4  
,in #agge he published an account of the
 medical powers of this animal          
magnetism1 which from his name was      
afterward called mesmerism4 ,paris was  
then the centre of attraction for       
scientific discoverers and pretenders4  
,thither ,mesmer betook himself and     

there he soon created a lively sensation
 by the exhibition of mesmeric trances1 
some of which were accompanied by       
clairvoyance--that is1 the power of     
seeing objects concealed from the eyes4 
,he was also supposed to work some      
inexplicable cures4  ,the secret of his 
art he could not be induced to reveal   
even for the sum of #cdj1jjj livres1    
which was offered him in compensation4  
,people began to doubt whether he had a 
real secret1 or whether he was a rank   
impostor4 ,a royal commission was       
appointed to examine into the matter4   
,our ,benjamin ,franklin1 then in       
,paris1 was one of the commissioners4   
,their report was unfavorable4 ,they    
found no proof of the existence of a    
fluid such as animal magnetism1 and     
thought that all that was not imposture 
could be accounted for by the power of  
imagination4 ,in a secret report they   
pointed out very strongly the dangers   
likely to arise from this unhealthy     
stimulus to the imagination4 ,their     

verdict does honor to their learning and
 their common-sense4 ,mesmer left       
,paris1 and he died in obscurity in     
#ahae4  ,but his pretended discovery did
 not die with him4 ,it was a mine of    
resources to charlatans and impostors   
generally4 ,there were strange effects  
produced1 and at the sight of the       
inexplicable men lose their wits4 ,the  
gullible public wondered1 restless minds
 experimented1 and many pondered        
thoughtfully on facts1 most of which    
were not facts at all4 ,but after       
eliminating all the elements of         
imposture and exaggeration there seemed 
to remain a residue of phenomena that   
were strange and unaccountable4   ,,ii4 
,,theory ,,of ,,hypnotism4  ,about #ahdj
 the vaunted claims of the many         
clairvoyants were exposed before the    
,french ,academy of ,medicine1 which    
passed a resolution rejecting mesmerism 
altogether as unworthy of notice on the 
part of scientific men4 ,the theory of a
 mesmeric fluid1 until then the only one

 advanced1 had evidently to be          
abandoned4 ,science with all its tests  
could find no such cause of the results 
produced4 ,but in #ahdb an ,english     
physician1 ,dr4 ,james ,braid1 hit upon 
a more plausible theory4 ,he conjectured
 that the actions of the mesmeric       
subject could be explained without a    
fluid by the suggestion of phantasms to 
him on the part of the mesmerizer4 ,dr4 
,carpenter1 then a great authority1     
defended his theory2 but the medical    
branch of the ,british ,association     
disdained to consider the matter4 ,dr4  
,braid thought the mesmeric trance was  
only a state of somnambulism            
artificially brought about1 and he      
coined the word hypnotism to indicate   
the artificial sleep4 ,other attempts to
 promote the cause of hypnotism were    
made in the ,united ,states and other   
lands1 but no very definite or          
scientific results were reached until   
#ahgh1 when the celebrated ,prof4       
,charcot and others made its nature and 

possibilities the subject of a thorough 
study and abundant experimentation at   
the ,paris hospital of ,la ,salptrire   
and in other places4 ,at present it is  
admitted by distinguished medical       
scientists that hypnotism is a reality1 
capable of being utilized for important 
purposes4 ,many effects have been       
demonstrated to be produced by it as    
real as any ordinary phenomena of       
nature4 ,but on the explanation of their
 causes there hangs still a cloud of    
obscurity4  ,the ,paris ,school of      
,doctors attribute the effects to       
physical causes1 chief among which are  
diseases of the nerves4 ,those of ,nancy
 trace the phenomena to a psychical     
source1 namely1 to suggestion--that is1 
action on the subject through his       
imagination excited by words1 signs1 or 
in any other manner4 ,this appears to   
be1 in the main1 the theory of ,dr4     
,braid vindicated by modern science4    
,probably enough1 both schools are right
 in their way1 the suggestions not      

taking effect except where nervous      
affections have prepared the way4 ,the  
beneficial results claimed for hypnotism
 by the scientific men who have made its
 study a specialty are chiefly as       
follows3   ,,iii4 ,,benefits ,,of       
,,hypnotism4  #a4 ,it acts as a         
temporary sedative1 quieting the excited
 nerves of the patient4 ,it was thus    
employed1 for instance1 on an old woman 
who was near her death1 and who had not 
been able to make necessary preparations
 for that important event1 being beside 
herself with nervous agitation4 ,she    
obtained by this means a calm condition 
for some seven or eight hours4          
,hypnotism was for her like the visit of
 a good angel from heaven4  #b4 ,it is  
used as an ansthetic in place of        
chloroform1 which in many cases cannot  
be applied without great danger to      
health1 or even life4 ,thus perfect     
insensibility may be procured and long  
continued1 allowing sometimes of the    
performance of protracted surgical      

operations that would otherwise be      
almost impossible4  #c4 ,at other times 
it is employed as a mere pain-killer    
without depriving the patient of        
consciousness1 so that the hurt is felt 
indeed1 but not attended with keen      
suffering4  #d4 ,it is claimed that the 
skilful application of hypnotism can at 
times not only alleviate the pain of an 
injury1 but even cure nervous affections
 more or less permanently1 removing1 for
 instance1 the defect of stammering4    
#e4 ,there are not wanting cases in     
which even moral improvements are       
claimed to be produced1 at least in the 
removing of bad habits1 such as         
drunkenness4 ,if hypnotism can cure     
intoxication permanently1 or even for a 
season1 it deserves to be encouraged4   
,yet even then it must be used with     
great caution1 for there may be very    
evil consequences resulting from its    
use4 ,to realize fully the dangers and  
the evils attendant upon hypnotism you  
must understand the three stages through

 which the patient is made to           
pass--those of lethargy1 catalepsy1 and 
somnambulism4   ,,iv4 ,,dangerous       
,,treatment4  ,each of these is a       
disease in itself1 and thus it is seen  
at once that a treatment which employs  
diseases as its means of cure must be of
 a dangerous kind4 ,after the patient   
has been hypnotized by any of the       
various processes--the chief are        
mesmeric passes of the hypnotizer's     
hands1 his eyes fixed into the eyes of  
his subject1 or the latter's on an      
object so held as to strain his         
eyes--the first stage of hypnotism is   
obtained1 that of lethargy4 ,in the     
lethargic state1 the subject appears to 
be sunk in a deep sleep2 his body is    
perfectly helpless2 the limbs hang down 
slackly1 and when raised fall heavily   
into the same position4 ,in this        
condition all the striated or voluntary 
muscles react on mechanical excitement4 
,without an accurate knowledge of       
anatomy1 much harm may be done by the   

experiment4  ,the second stage is that  
of catalepsy1 certainly not a healthy   
condition to be in4 ,its grand feature  
is a plastic immobility by which the    
subject maintains all the attitudes     
given to his body and limbs1 but with   
this peculiarity1 that the limbs and    
features act in unison4 ,join the hands 
of the patient as if in devout prayer1  
and his countenance assumes a devout    
expression2 clench his fist1 and anger  
is depicted in his features4  ,the third
 stage is that of somnambulism4 ,the    
skin is now insensible to pain1 but     
excessive keenness is manifested in the 
sight1 hearing1 smell1 and muscular     
sense4 ,here the impostor can play off  
his pretended clairvoyance or second    
sight2 for the subject will discover    
objects hidden from sight by the sense  
of smell and other senses affected with 
abnormal power4 ,the somnambulist will  
now exhibit the utmost sensibility to   
suggestions made to him by the          
hypnotizer1 so that he seems to be      

almost entirely controlled by the       
influence of the latter's will4 ,this is
 what chiefly favored the early theory  
that a mesmeric fluid emanated from the 
mesmerizer by means of which he could   
act in his subject as he pleased4 ,the  
experiment by suggestions seems to      
succeed best with hysterical patients1  
which fact confirms the morbid character
 of the hypnotic trance4   ,v4 ,,field  
,,for ,a ,,scientist4  ,if any          
distinguished scientist or ,doctor who  
can afford it wishes to make a special  
study of hypnotism1 which is still so   
imperfectly understood1 he may render a 
valuable service to humanity1 and in    
particular to the science of medicine4  
,but if any ordinary physician asked my 
advice about devoting attention to this 
pursuit4 ,i would emphatically tell him1
 ,leave it alone3 you are not likely to 
derive real benefit from it1 and you are
 very likely to inspire your clients    
with distrust of you when they see you  
deal with matters which have deserved a 

bad name on account of the charlatanism 
and the superstitious abuses usually    
connected with them4 ,this is not my    
opinion alone1 but also that of         
distinguished writers on the subject4   
,,vi4 ,,objections ,,to ,,hypnotism4    
,when there is question of hypnotic     
sances or exhibitions such as are       
designed to feed the morbid cravings of 
the public for what is mysterious and   
sensational1 ,i would call special      
attention to the following objections   
against such practices4  #a4 ,medical   
authorities maintain that it requires at
 least as much knowledge of therapeutics
 to use hypnotism safely as it does for 
the general practice of medicine1 and   
requires of a physician who engages in  
it a more thorough mastery of his       
profession than many other branches of  
the healing art1 and therefore that it  
is as objectionable to allow            
non-professionals to deal with hypnotism
 as it would be to allow medical        
practice promiscuously to all persons   

without a ,doctor's diploma4 ,in fact1  
in ,russia1 ,prussia1 and ,denmark none 
but licensed physicians can lawfully    
practise hypnotism4 ,aside from a       
variety of accidents which may result to
 the subject hypnotized from the        
ignorance of physiology in the          
hypnotizer1 there is this general injury
 sustained1 that even strong subjects   
frequently experimented upon contract a 
disposition to be readily thrown into   
any of the three morbid states of the   
mesmeric trance4 ,all these states are  
real diseases and are allied to         
hysteria1 epilepsy1 and a whole family  
of nervous troubles1 any one of which is
 sufficient to make a patient very      
miserable for life1 and even to lead him
 to an early grave4  #b4 ,the moralist  
has still stronger objections against   
the use of hypnotism1 except when it is 
used as a means to most important       
results4 ,he maintains that one of the  
greatest evils that can befall a man is 
the weakening of his will-power2 this   

leaves him a victim to the cravings of  
his lower appetites4 ,now the frequent  
surrender of one's will to the control  
of another is said 7very reasonably1 it 
would seem7 to bring on a weakening of  
the will or self-control4 ,we see this  
exemplified in the habitual drunkard4   
,he loses will-power to such an extent  
that he can scarcely keep his most      
solemn promises or withstand the        
slightest temptations4 ,there is a very 
serious question asked by the moralist  
upon another resemblance of an hypnotic 
subject to a drunkard4 ,he asks whether 
any man has a right for the amusement   
perhaps of the curious lookers-on to    
forfeit for awhile his manhood1 or the  
highest privilege of his manhood--his   
powers of intellect and free-will4 ,he  
admits that we do so daily in our sleep4
 ,but then he argues that sleep is a    
necessity of our nature directly        
intended by the ,creator1 a normal part 
of human life4 ,besides it is a         
necessary means for the renewal of our  

strength1 and on the plea of necessity  
the moralist may admit the use of       
hypnotism when it is needed for the cure
 of bodily diseases4 ,but for the mere  
amusement of spectators he maintains    
that it is wrong for a man thus to      
resign his human dignity1 as it would be
 wrong for him to get drunk for the     
amusement of lookers-on4 ,still1 in this
 latter case the evil would be greater1 
for in drunkenness there is contained a 
lower degradation1 inasmuch as the baser
 passions are then left without all     
control1 and are apt to become          
exceedingly vile in their licentious    
condition4 ,the hypnotic subject has at 
least the mind and will of the          
hypnotizer to direct him4 ,here1        
however1 appears the need of another    
caution1 namely1 that the hypnotizer    
should be known to be a virtuous man2   
else the evil that he can do to his     
subject1 as is readily seen1 may be even
 worse than that resulting from a fit of
 drunkenness4 ,and as men who occupy    

even respectable positions may yet be   
vile at heart1 it is very desirable for 
prudence' sake to have no one hypnotized
 in private without the presence of a   
parent1 close relative1 or some other   
party1 who will see to it that nothing  
improper be suggested during the trance4
 ,for the scenes gone through during the
 hypnotic state1 though not remembered  
by the subject upon his return to       
consciousness1 are apt to recur to him  
afterwards like a dream1 showing that   
they have left traces behind them4  #c4 
,legal writers and lawyers have serious 
charges against hypnotism4 ,this        
practice1 they maintain1 if publicly    
exhibited to old and young1 begets      
dangerous cravings for sensational      
experiments4 ,turning away men's        
attention from the sober realities and  
duties of social life1 it prompts them  
to pursue the unnatural and abnormal4   
,it was this craving that in less       
enlightened ages led men to the         
superstitious practice of astrology and 

witchcraft4 ,at present it leads to such
 vagaries and unchristian and often     
immoral practices as are connected with 
spiritism1 faith-cures1 mind-reading1   
and similar foolish or criminal or at   
least dangerous experimentations which  
dive into the dark recesses found in the
 border-land of the preternatural4 ,the 
atmosphere of that region is morally    
unhealthy and should be barred off by   
the guardians of public morals4  ,the   
most common objection of legal writers  
is directed against the various crimes  
to which hypnotism is apt to lead men of
 criminal propensities4 ,they point to  
the statements of ,dr4 ,luys1 a         
respectable authority on hypnotism1 who 
says3 ,a patient under the influence of 
hypnotism can be made to swallow poison1
 to inhale noxious gases4 ,he can be led
 to make a manual gift of property1 even
 to sign a promissory note or bill1 or  
any kind of contract4 ,indeed1 how can  
notaries or witnesses suspect any fraud 
when even the ,doctor needs all his     

experience and all his skill to avoid   
falling into error8 ,in criminal matters
 a man under suggestion can bring false 
accusations and earnestly maintain that 
he has taken part in some horrible      
crime4   ,,vii4 ,,further ,,explanation 
,,of ,,hypnotism4  ,after considering   
the objections to the use1 or rather    
abuse1 of hypnotism1 ,i may add some    
further explanation of hypnotism        
itself--of its nature so far as it is   
known to science4 ,science has          
ascertained the reality of the phenomena
 and facts--not single facts only1      
scattered here and there1 but groups of 
facts uniformly obedient to certain laws
 of nature4 ,it has not yet discovered  
the exact cause or causes of all these  
phenomena1 but it gives plausible       
explanations of them1 both in the       
physical theory of the ,paris ,school   
and in the psychical theory of the      
,nancy ,school of ,physicians4 ,science 
has discarded the original theory of a  
mesmeric fluid as the cause of these    

phenomena1 just as it has discarded the 
formerly supposed fluids of electricity 
and magnetism4 ,of electricity the      
,century ,dictionary says3 ,a name      
denoting the cause of an important class
 of phenomena of attraction and         
repulsion1 chemical decomposition1 and  
so on1 or1 collectively1 these phenomena
 themselves4 ,the true nature of        
electricity is as yet not all           
understood1 but it is not1 as it was    
formerly supposed to be1 of the nature  
of a fluid4 ,similarly we may define    
hypnotism as the collection of peculiar 
phenomena of a trance or sleep          
artificially induced1 or the induced    
trance or sleep itself4  ,the true cause
 of these phenomena is not yet          
understood1 but there is no apparent    
reason for attributing them to a special
 fluid2 they seem to be peculiar ways of
 acting1 belonging to man's physical    
powers when his nerves are in an        
abnormal condition4 ,by laying down     
these definite statements we gain the   

advantage that we isolate hypnotism from
 the frauds and empty shades1 from the  
ghosts and hobgoblins with which it used
 to be associated in the border-region  
which we have undertaken to explore4    
,science deals with well-ascertained    
facts4 ,now of mesmerism1 animal        
magnetism1 and its kindred1 odylism1 we 
have seen that we have no reliable      
facts4 ,we have done with those         
unsubstantial shades4 ,but of hypnotism 
we have well-known facts1 and we have   
shown it to be placed on a scientific   
basis4   ,,viii4 ,,science ,,dreads     
,,error4  ,of clairvoyance1             
mind-reading1 palmistry1 spiritual      
science cures we have no certain facts1 
but we have many impostures connected   
with them4 ,if ever we get real and     
undoubted facts proved to be connected  
with them1 we ought to examine them with
 care4 ,science is not afraid of any    
portion of nature2 all it dreads is     
ignorance1 and what is worse1 error4    
,error with regard to facts may be      

committed in two ways--by admitting as  
facts what are not facts1 and by denying
 facts4 ,now1 there are facts certain   
and well ascertained1 numerous and      
widely known1 connected with some other 
portions of the border-land of science  
that we have not yet looked into1 though
 ,i have mentioned their names4 ,he who 
would assert that spiritism1            
table-turning1 spirit-rapping1 and so on
 are mere idle talk1 sheer impostures1  
is not well read in the literature of   
the present day4 ,by denying all reality
 to these phenomena he strays as far    
from the truth as if he allowed himself 
to believe mere fabrications4 ,they are 
not impositions1 but they are worse2    
they are superstitions4 ,by             
superstitions ,i mean here the practice 
of producing results which cannot       
possibly proceed from the powers of     
nature1 and which could not without     
absurdity be attributed to the          
interference of the ,creator or ,his    
good angels4  ,some persons strenuously 

object to introducing any reference to  
,god into scientific works4 ,science    
consists in tracing known effects to    
their true causes4 ,if there were no    
,god1 ,he could not be a true cause and 
it would be unscientific to introduce   
,his agency4 ,but if there is a ,god and
 ,he acts in the world which ,he has    
made1 we must take ,his actions into    
account when we study ,his works4 ,some 
say1 ,i do not believe in a ,god4 ,that 
may be1 but that does not prove that    
there is no ,god4 ,belief is a man's    
wilful and fine acceptance of what is   
proposed to him on the authority of some
 one else4 ,students have most of their 
knowledge on the authority of their     
professors and other men of learning4   
,if a medical student would say1 ,i do  
not believe in microbes nor in contagion
 by disease germs1 that would not kill  
the germs nor protect him against       
contagion4 ,nor would it show his       
superior wisdom1 but rather his         
extravagant conceit and ignorance4 ,so  

with those who believe not in ,god4     
,there are others who believe not in the
 existence of devils or fallen angels4  
,that is not so bad2 but yet they must  
remember that their refusal to believe  
in devils does not prove that there are 
none4 ,the greatest enemies of science  
are those who blindly maintain false    
statements and false principles of      
knowledge4 ,let us look for the truth in
 every investigation4 ,even ,huxley1 in 
the midst of his attacks on dogmatic    
religion1 protests also against dogmatic
 infidelity4 ,science1 he says1 is as   
little atheistic as it is materialistic4
 ,all this must be remembered chiefly   
when we undertake to explore1 as we are 
now doing1 the unknown region which we  
have called the border-land of science4 
,there we find many strange phenomena1  
and we are trying to discover their true
 nature and true causes4 ,if we can     
explain some of them by natural causes1 
as by the powers of the imagination when
 it is in an abnormal or hypnotic state1

 very well1 let us explain them4 ,but   
let us not rashly conclude that all     
other phenomena can be thus explained4  
,do not reason this way1 as some writers
 have done3 ,some effects1 they say1    
were formerly attributed to witchcraft  
or deviltry and can now be explained by 
hypnotism4 ,therefore all other         
mysterious effects can also be thus     
explained4 ,therefore there is not and  
never was such a thing as witchcraft or 
deviltry4 ,so1 too1 some events often   
reputed miraculous can be explained by  
natural causes1 therefore no miracle has
 ever happened4 ,that is the reasoning  
of rash and ignorant men1 and not of    
scientific minds4 ,it does not follow   
from the fact that ,god usually works by
 natural causes1 that ,he cannot on     
special occasions and for very important
 reasons show ,his hand1 as it were1 and
 act so manifestly against the course of
 nature as to show us that it is ,he who
 is at work and ,he wants us to mind    
,him4 ,history furnishes many instances 

of this kind4   ,,ix4 ,,credentials ,,of
 ,,christ4  ,least of all have          
,christians a right to deny this1 and we
 must remember that the civilized world 
is ,christian1 almost entirely4         
,christians believe in the reliability  
of the ,bible1 and in it we are         
constantly informed of countless        
miracles in various ages4 ,if all these 
accounts are false1 then ,christianity  
is a vast imposture4 ,christ appealed to
 them as to ,his credentials in ,his    
mission to the world4 ,if you do not    
believe ,me1 ,he said1 believe ,my      
works1 for they give testimony of ,me4  
,the blind see2 the lame walk2 the dead 
are raised to life4 ,if ,he spoke       
falsely1 ,he was a deceiver2 if ,he     
worked those marvels by hypnotism1 or   
any other natural cause1 ,he was an     
impostor4 ,there is no middle way4      
,either by working true miracles ,he    
proved ,himself to be what ,he claimed  
to be1 the ,son of ,god1 or ,he was the 
most bold and detestable impostor that  

has ever appeared on earth4 ,this no    
,christian can suppose1 this no         
historian would admit2 therefore1 we    
must grant that ,he worked miracles1 and
 miracles are realities to be taken into
 account by the writers of history1 and 
scientific workers must not sneer at    
them4   ,x4 ,,deviltry4  ,scientific men
 in their investigations need not expect
 to come into contact with miracles2 but
 they may and do find in the border-land
 of science facts which reveal the      
agency of intellectual beings distinct  
from men1 and too vulgar in their       
manifestation to be confounded with ,god
 or ,his blessed angels4 ,such agents in
 the book of the ,scriptures are called 
devils1 and intercourse with them is    
styled superstition1 seeking their      
assistance is magic or witchcraft1 and  
consulting them is divination or        
fortune-telling4 ,all these practices   
are directly and strictly forbidden in  
the ,scriptures1 and yet they are       
commonly enough in use in our own day to

 procure effects that gratify the       
curiosity of such1 especially1 as have  
no settled belief in supernatural       
religion4  ,some of these effects are   
connected with bodily cures and thus are
 of interest to physicians4 ,for        
instance1 spiritualistic mediums1       
whether connecting their practices with 
magnetism or not1 though entirely       
ignorant of medicine1 are at times able 
to state the exact bodily indisposition 
of sick persons living at a great       
distance1 put into communication with   
them by holding some object belonging to
 them4 ,they will indicate the seat of  
the disorder1 its nature and progress1  
its complications4 ,they propose simple 
and efficacious remedies1 using not     
infrequently technical terms which are  
certainly unknown to them before4 ,they 
manifest the thoughts of others1 reveal 
family secrets1 answer questions put in 
languages of which they know nothing4   
,to deny facts attested by thousands of 
witnesses of various nations belonging  

to various religious denominations or   
professing no religion whatever1 is not 
the spirit of science4 ,it it estimated 
that #ajj1jjj spiritist books and       
pamphlets are sold yearly in the ,united
 ,states alone4 ,it is certain that     
much1 very much imposture is mixed up   
with many undeniable facts1 but that    
does not dispose of the real facts mixed
 up with the impostures4 ,tyndall once  
caught an ill-starred spiritualistic    
impostor at his juggling4 ,he concluded 
that all other spiritists were          
impostors4 ,the world now laughs at him 
for his foolish reasoning4  ,of course1 
,i do not suppose that spiritism is     
mainly employed in such matters as would
 directly interest the physician4 ,it   
has grown into a system of religion and 
morals1 very peculiar and at variance   
with the ,christian religion1 a system  
rather resembling the religion of       
,buddha1 with its reincarnations and    
transmigrations of souls while          
struggling after eternal after-progress4

 ,this is fully and clearly explained in
 an article on ,spiritism in its ,true  
,character in the ,english publication  
called ,the ,month1 for ,september1     
#ahib4 ,but with this phase of it we are
 not now concerned4 ,as to the facts1 it
 is enough to remark that spiritists    
claim a following of #bj1jjj1jjj4       
,suppose there are only one-half that   
number4 #aj1jjj1jjj people are not      
readily deceived about matters of their 
daily observation1 for their meetings or
 sances consist chiefly of those        
manifestations which others call        
impostures4  ,their adherents are       
chiefly among the educated classes1 ,i  
believe4 ,certainly they include        
multitudes of doctors1 lawyers1         
professors1 scientists1 magistrates1    
clergymen1 close students1 keen         
intellects1 even such men as ,alfred    
,russell ,wallace1 ,profs4 ,morgan1     
,marley1 ,challis1 ,william ,carpenter1 
and ,edward ,cox4 ,if one has still     
lingering doubts on this matter let him 

read the four learned articles written  
by my predecessor in this chair of      
,medical ,jurisprudence1 ,rev4 ,james   
,f4 ,hoeffer1 ,s4,j41 the former        
president of ,creighton ,university4    
,they are found in the ,american        
,catholic ,quarterly ,review for #ahhb  
and #ahhc4  ,what must we think of the  
nature of spiritism1 with its           
spirit-rappings1 table-turning1         
spirit-apparitions1 and so on8 ,can such
 of the facts as are not impostures and 
realities be explained by the laws of   
nature1 the powers of material agents   
and of men8 ,all that could possibly be 
done by the most skilled scientists1 by 
the most determined materialists who    
believe neither in ,god nor demon1 as   
well as by the most conscientious       
,christians1 has only served to         
demonstrate to perfect evidence that    
effects are produced which can no more  
be attributed to natural agency than    
speech and design can be attributed to a
 piece of wood4 ,one principle of       

science throws much light on the nature 
of all those performances1 namely1 that 
every effect must have a proportionate  
cause4 ,when the effect shows knowledge 
and design1 the cause must be           
intelligent4 ,now many of these marvels 
evidently show knowledge and design2    
therefore the cause is certainly        
intelligent4  ,a table cannot understand
 and answer questions2 it cannot move at
 a person's bidding4 ,a medium cannot   
speak in a language he has never        
learned1 nor know the secret ailment of 
a patient far away1 nor prescribe the   
proper remedies without knowledge of    
medicine4 ,therefore these effects1 when
 they really exist1 are due to          
intelligent agents1 agents distinct from
 the persons visibly present2 invisible 
agents1 therefore1 spirits of another   
world4  ,who are these agents8 ,god and 
,his good angels cannot work these      
wretched marvels1 the food of a morbid  
curiosity1 nor could they put themselves
 at the disposal of impious men to be   

marched out as monkeys on the stage4    
,the spirits which are made to appear at
 the sances are degraded spirits4       
,spiritualists themselves tell us they  
are lying spirits4 ,those lying spirits 
say they are the souls of the departed1 
but who can believe their testimony if  
they are lying spirits1 as they are     
acknowledged to be8 ,this whole         
combination of imposture and            
superstition is simply the revival in a 
modern dress of a very ancient deception
 of mankind by playing on men's craving 
for the marvellous4 ,many imagine these 
are recent discoveries1 peculiar to this
 age of progress4 ,why8 ,this           
spirit-writing is and has been for      
centuries extensively practised in      
benighted pagan ,china1 while even      
,africans and ,hindoos are great adepts 
at table-turning4 ,it is simply the     
revival of ancient witchcraft1 which    
,simon ,magus practised in ,st4 ,peter's
 time2 which flourished in ,ephesus     
while ,st4 ,paul was preaching the      

,gospel there4 ,it is more ancient      
still4 ,these were the abominations for 
which ,god commissioned the ,jews in    
,moses' time to exterminate the         
,canaanites and the other inhabitants of
 the ,promised ,land4 ,in the ,book of  
,moses called ,deuteronomy1 or ,second  
,law1 admitted as divine by ,catholics1 
,protestants1 and ,jews alike1 we have  
this fact very emphatically proclaimed  
by the ,lord4 ,he says3 ,when thou art  
come into the land which the ,lord thy  
,god shall give thee1 beware lest thou  
have a mind to imitate the abominations 
of those nations2 neither let there be  
found among you any one that 444        
consulteth soothsayers1 or observeth    
dreams and omens1 neither let there be  
any wizard1 nor charmer1 nor any one    
that consulteth pythonic spirits1 or    
fortune-tellers1 or that seeketh the    
truth from the dead4  ,is not this just 
what spiritualists pretend to do8 ,many 
may call it only trifling and play4 ,the
 ,lord does not4 ,the ,scriptures       

continue3 ,for the ,lord abhorreth all  
these things1 and for these abominations
 ,he will destroy them at thy coming4 ,i
 certainly do not mean to say that all  
that passes for spiritualism is thus    
downright deviltry to-day1 nor was it so
 in pagan times4 ,much imposture was    
mixed with it4 ,the oracles of the pagan
 gods and goddesses were not all the    
work of the pythonic spirits4 ,much was 
craft of the priests of idols2 and yet  
all were abominations before the ,lord1 
on account of the share that ,satan took
 in the deceptions4  ,what must be the  
attitude of the scientific man towards  
all such matters8 ,it should be an      
attitude of hostility and opposition4   
,science should frown down all imposture
 and superstition4 ,medicine in         
particular1 intended to be one of the   
choicest blessings of ,god to man1      
should not degrade its noble profession 
by pandering to a vulgar greed for      
morbid excitement4 ,not only will you   
personally keep aloof from all that is  

allied to quackery and imposture1 but in
 after-life your powerful influence for 
good will be most efficient in guarding 
others against such evils1 and even     
perhaps in withdrawing from such        
associations those who have already got 
entangled in dangerous snares4 ,at all  
events the enlightened views you shall  
have formed to yourselves on all such   
impostures and impieties will be a power
 for good in the social circle in which 
your mental superiority and your moral  
integrity will make you safe guides for 
your fellow-men4   ,,printed ,,by       
,,benziger ,,brothers1 ,,new ,,york