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ABORTION.

Abortion, gentlemen, is the theme of my present lecture.

The Schoolmen of the Middle Ages, while condemning abortion from the time of conception, preferred the opinion of Aristotle, that the rational soul is not infused till the foetus is sufficiently developed to receive it. The embryo lived first, they taught, with a vegetable life; after a few days an animal soul replaced the vegetative principle; the human soul was not infused into the tiny body till the fortieth day for a male, and the eightieth day for a female child. All this sounds very foolish now; and yet we should not sneer at their ignorance; had we lived in their times, we could probably have done no better than they.

It was not till 1620 that Fienus, a physician of Louvain, in Belgium, published the first book of modern times that came near the truth. He maintained that the human soul was created and infused into the embryo three days after conception. Nearly forty years later, in 1658, a religious priest, called Florentinius, wrote a book in which he taught that, for all we know, the soul may be intellectual or human from the first moment of conception; 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 soul.

"The usual impression," the authors add, "and one which is probably still maintained by the mass of the community, is that the embryo is perfected at the period of quickening--say the one hundred and twelfth or one hundred and twentieth day. When the mother first perceives motion, is considered the period when the foetus becomes animated--when it receives its spiritual nature into union with its corporeal.

"These and similar suppositions are, as has been already shown, contrary to all fact, and, if it were not for the high authorities--medical, legal, and theological--in opposition, we might add, to common-sense."

At present, gentlemen, there seems to be no longer any authority to the contrary. But many people, and some Doctors, seem to be several generations behind the times; for they still act and reason as if in the first weeks of pregnancy no immortal or human soul were in question.

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 ago, when the mother of a highly respected family, then in my spiritual charge, was wasting away with consumption during her state of pregnancy. You know that we Catholics are very solicitous that infants shall not die without Baptism, because we believe that heaven is not promised to the unbaptized. I therefore directed the lady's husband to consult their family physician on the prospects of the case, and take timely precautions, so that, if death should come on the mother before her delivery, the infant might be reached at once and be baptized before it expired. The physician, a learned and conscientious practitioner, answered that we should not be solicitous; for that Nature had so provided that mothers in such cases rarely die before the child is born. He was right. The child was born and baptized; the mother died a few hours later; the little one lived several weeks before it went to join the angels in heaven. 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 reality, and we are rarely justified in interfering with the natural progress of gestation."

To return to our subject. Abortion, or miscarriage, is often, as you know, gentlemen, the result of natural causes beyond human control; at other times it is brought on by unintentional imprudence on the part of the mother or her attendants. It is the duty of the family physician, when occasions offer, to instruct his pregnant patients and other persons concerned on the dangers to be avoided. A good Doctor should be to his patients what a father is to his children; very important matters are confided to him, and therefore grave responsibilities rest on his conscience.

This conduct requires four conditions: 1. That we do not wish the evil itself, but make all reasonable effort to avoid it. 2. That the immediate effect we wish to produce is good in itself. 3. That the good effect intended is at least as important as the evil effect permitted. 4. That the evil is not made a means used to obtain the good effect.

Now let us apply these principles to the case in hand.

Is it not strange then, very strange, that they who thus falsely accuse us are often the very men who will procure an abortion to save the mother's life, who will do wrong that good may come of it? And you find such men maintaining the lawfulness of abortion on the plea that the operation, whether licit or not, is a necessary means to obtain a good end.

The passions of men are insatiate, even in modern society; the more you yield to them, the stronger grows their craving. Let me illustrate my meaning by a fact that happened a few years ago in Russia. It is just to our point. During a severe winter, a farmer, having his wife and children with him on a wagon, was driving through a wild forest. All was still as death except the howling of wolves in the distance. The howling came nearer and nearer. After a while a pack of hungry wolves was seen following in the track of the wagon. The farmer drove on faster, but they gained on him. It was a desperate race to keep out of their reach. At last they are just back of the wagon. What can be done? The next moment the wolves may jump on the uncovered vehicle. The children, horrified, crouch near their trembling mother. Suddenly the father, driven to despair, seizes one of the little children and flings it among the pack of wolves, hoping that by yielding them one he may save the rest. The hungry beasts stop a few moments to fight over their prey. But soon they are in hot pursuit again, fiercer because they have tasted blood. A second child is thrown to them, and after a while a third and a fourth.

Human society, gentlemen, in this matter of sacrificing foetal life is as insatiable as a pack of hungry wolves. Woe to any one of you if he begins to yield to its cravings; there is no telling where he will stop. In proof of my statement, let me read to you an extract from a lecture on Obstetrics, delivered by Doctor Hodge, of Philadelphia, to the medical students of the University of Pennsylvania: "We blush while we record the fact, that, in this country, in our cities and towns, in this city where literature, science, morality, and Christianity are supposed to have so much influence; where all the domestic and social virtues are reported as being in full and delightful exercise; even here individuals, male and female, exist who are continually imbruing their hands and consciences in the blood of unborn infants; yea, even medical men are to be found who, for some trifling pecuniary recompense, will poison the fountains of life, or forcibly induce labor, to the certain destruction of the foetus and not infrequently of the parent.

"So low, gentlemen, is the moral sense of the community on this subject, so ignorant are the greater number of individuals, that even mothers, in many instances, shrink not from the commission of this crime, but will voluntarily destroy their own progeny, in violation of every natural sentiment and in opposition to the laws of God and man. 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 to destroy the fruit of illicit pleasure, under the vain hope of preserving their reputation by this unnatural and guilty sacrifice.

"Married women, also, from the fear of labor, from indisposition to have the care, the expense, or the trouble of children, or some other motive equally trifling and degrading, have solicited that the embryo should be destroyed by their medical attendant. And when such individuals are informed of the nature of the transaction, there is an expression of real or pretended surprise that any one should deem that act improper, much more guilty; nay, in spite even of the solemn warnings of the physician, they will resort to the debased and murderous charlatan, who, for a piece of silver, will annihilate the life of the foetus, and endanger even that of its ignorant or guilty mother.

"These facts are horrible, but they are too frequent and too true; often, very often, must all the eloquence and all the authority of the practitioner be employed; often he must as it were grasp the conscience of his weak and erring patient, and let her know, in language not to be misunderstood, that she is responsible to her Creator for the life of the being within her."

Dr. Walter Channing, of Massachusetts, refers to the difficulty of obtaining a conviction for abortion, and adds: "I believe there has never been one in this State, this moral State by eminence, and perhaps in none is this crime more rife." .

Gentlemen, when such authorities disagree, I would not presume to attempt a theoretic decision. But then we have this other principle practically to guide us, that in matters so very doubtful we need not condemn those who differ from our view, as long as they feel convinced that they are acting wisely and prudently. In Jurisprudence, reason must be our guide when it affords us evidence of the truth. But when our reason offers arguments on both sides of the question, so that we can arrive at no certain conclusion, then we act prudently by invoking the authority of wiser minds who make moral questions a speciality, and we are perfectly safe if we follow the best authority obtainable.

A Catholic physician has here a special advantage: for he has in cases of great difficulty the decisions of Roman tribunals, composed of most learned men, and renowned for the thoroughness of their investigations and the prudence of their verdicts, to serve him as guides and vouchers for his conduct. Although these tribunals claim no infallibility, yet they offer all the advantages that we look for, with regard to civil matters, in the decisions of our Supreme Court. These Roman courts have uniformly decided against any operation tending directly to the death of an innocent child .

Non-Catholics are, of course, not obliged to obey such pronouncements; yet, even for them, it cannot be injurious, but rather very useful, to know the views of so competent a court on matters of the most vital interest in their learned profession. 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 .

VIEWS OF SCIENTISTS AND SCIOLISTS.

In my former lectures, gentlemen, I explained to you the principles condemnatory of craniotomy and abortion, viewing these chiefly from the standpoint of the ethical philosopher and the jurist. Not being a physician myself, I think it proper, on matters of so much importance, to quote here freely from a lecture delivered on this subject by a late professional gynecologist, an old experienced practitioner, who was for many years a professor of obstetrics in the St. Louis Medical College. I quote him with the more pleasure because of my personal acquaintance with him, and of the universal esteem for ability and integrity in which he was held by the medical profession.

Dr. L. Charles Boislini?re, to whom I refer, had by his scientific acquirements and his successful practice, during forty years of his life, become, to a great extent, identified with the progress of the science of obstetrics in this country; and a few months before his late demise, he had published a useful work on "Obstetric Accidents, Emergencies, and Operations."

In 1892 he read, before the St. Louis Obstetrical and Gynecological Society, a lecture on the moral aspects of craniotomy and abortion, of which a considerable portion is very much to our present purpose. The Doctor herein clearly demonstrates that, in this matter at least, Ethics and Medical Science are to-day perfectly concordant. He says:

"The operation of craniotomy is a very old one. The ancients entertained the belief that, in difficult labors, the unborn child was an unjust aggressor against the mother, and must, therefore, be sacrificed to save her life.

"Hippocrates, Celsus, Avicenna, and the Arabian School invented a number of vulnerating instruments to enter and crush the child's cranium. With the advance of the obstetric art, more conservative measures were gradually adopted, such as the forceps, version, induction of premature labor, and, finally, Cesarean section.

"Cesarean section is reported to have been performed by Nicola de Falcon in the year 1491. Nufer, in 1500, and Rousset, in 1581, performed it a great many times, always successfully; so that, Scipio Murunia affirms, it was as common in France during that epoch as blood-letting was in Italy, where at that time patients were bled for almost every disease. However, a reaction soon followed, headed by Guillemau and Ambrose Pare, who had failed in their attempts at Cesarean section. In our days a marked change of opinion on this interesting and delicate question is rapidly taking place.

"With these advances in view, the question now is:

"This is a burning question, and the sooner and more satisfactorily it is settled, the greater will be the peace to the medical mind and conscience.

"The case is that of the British yacht 'Mignonette.' On July 5, 1884, the prisoners Dudley and Stevens, with one Brookes and the deceased, an English boy between 17 and 18 years of age, part of the crew of the 'Mignonette,' were cast away in a storm at sea 1,600 miles from the Cape of Good Hope, and were compelled to take to an open boat.

"They had no supply of water, no supply of food, and subsisted for twenty days on two pounds of turnips and a small turtle they had caught. They managed to collect a little rain-water in their oil-skin capes.

"On the eighteenth day, having been without food for seventeen days and without water for five days, the prisoners suggested that some one should be sacrificed to save the rest. Brookes dissented, and the boy, to whom they referred, was not consulted. On that day Dudley and Stevens spoke of their having families, and of their lives being more valuable than that of the boy. The boy was lying in the bottom of the boat, quite helpless, extremely weak and unable to make any resistance; nor did he assent to be killed to save the others. Dudley, with the assent of Stevens, went to the boy and, telling him that his time had come, put a knife into his throat and killed him. They fed upon his flesh for four days. On the fourth day the boat was picked up by a passing vessel, and the sailors were rescued, still alive but in a state of extreme prostration.

"The prisoners were carried to the port of Falmouth and committed for trial, the charge being murder. Their excuse was that, if they had not killed the boy and fed upon his flesh, there being no sail in sight, they would have died of starvation before being rescued. They said that there was no chance of saving their lives, except by killing some one for the others to eat. The prisoners were committed for murder and sentenced to death, but appealed to the mercy of the court, pleading ignorance. It was found by the verdict that the boy was incapable of resistance, and authorities were then quoted to prove that, in order to save your own life, you have the right to take the life of an unjust aggressor in self-defence--a principle the truth of which is universally admitted.

"But the evidence clearly showed that the defenceless boy was not an unjust aggressor against their lives, and, consequently, their only plea was that of expediency.

"In a chapter in which he deals with the exception created by necessity, Lord Hale, quoted by Justice Coleridge, thus expresses himself:

"'If a man be desperately assaulted and in peril of death, and cannot otherwise escape, except by killing an innocent person then present, the act will not acquit him of the crime and punishment of murder; for he ought rather to die himself than to kill an innocent.'

"This case is exactly analogous to that of the child lying helpless in its mother's womb. She causes its death by her consent to the act of her agent, the physician in attendance.

"Remark that Brookes, one of the sailors, dissented to the killing of the sailor-boy. This may happen in consultation, when one of the consultants does not admit the right to kill an unborn child. Please also remember that the sailor-boy lay helpless at the bottom of the boat when his assailants killed him to save their own lives.

"The child is not an unjust aggressor against the mother. It is placed in the womb without its consent and is defenceless. It is the mother who is, as it were, the aggressor from the obstacles caused by a deformed pelvis, tumors, etc.; and she has not the right to ask or consent to the killing of the child who does not attack her.

"Therefore, I repeat that the two cases are analogous; and if, as remarked by Justice Coleridge, murder was committed in the first instance, so is murder committed in the analogue. So, we see, the principal points of the opinion enunciated by the learned judge, and the principles therein laid down, can, with equal force, be applied to the non-justification of craniotomy, by which the life of a defenceless child is sacrificed to save the mother.

'Macduff was from his mother's womb untimely ripped.'

"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 law. In the case of the murdered sailor-boy, there was not such an excuse, unless the killing was justified by what has been called necessity. But, as stated above, there never is an excuse for killing an innocent aggressor, and the temptation to the act and its expediency is not what the law has ever called necessity. Nor is this to be regretted; 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 deed, there would have been no guilt in the case. Happily this is not so. The plea of necessity once admitted might be made the legal cloak for unbridled passions and atrocious crimes, such as the producing of abortion, etc.

"As in the case of this young sailor, so in the killing of an unborn child, no such excuse can be pleaded; the unborn child cannot be the aggressor, no more so than the defenceless sailor-boy was.

"To preserve one's life is, generally speaking, a duty: but it may be the plainest duty, the highest duty, to sacrifice one's life. War is full of such instances in which it is not man's duty to live, but to die. The Greek and Latin authors contain many examples in which the duty of dying for others is laid down in most glowing and eloquent language.

"Thus, as a parallel case, is the situation of a woman in a difficult labor, when her life and that of her unborn child are in extreme danger. In this instance, it is the mother's duty to die rather than to consent to the killing of her child.

"In a subject of such delicacy and importance I have avoided all argument based upon the doctrines of any particular religion, and considered the subject upon its purely ethical and scientific basis. I am aware that I am taking a position quite at variance with that occupied by many men influenced by former teachings and prejudices.

"I respect the honest convictions of those opposed to the opinions presented in this paper. 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 child.

"As a hopeful sign, it is to be noticed that a gradual change is taking place in the opinions of the profession as to the propriety of performing craniotomy. Busey says: 'To state the issue plainly, the averment must be made that no conscientious physician would deliberately and wilfully kill a foetus, if he believed that the act was a violation of the commandment "Thou shalt not kill."' It has been well said by Barnes, the ablest and most conservative defender of craniotomy, that 'it is not simply a question for medicine to decide. Religion and the civil law claim a preponderating voice. In the whole range of the practice of medicine, there arises no situation of equal solemnity.'

"Having thus far considered the subject from a purely ethical standpoint, I shall now present its scientific and practical aspect.

"Parvin says that the improved Cesarean section has given in Germany results so satisfactory that, possibly, the day is at hand when craniotomy upon the living foetus will be very rarely performed, if done at all. Kinkead, a high English authority, states: 'To reduce the bulk of the child, or to extract it afterward through a pelvis of two and one-half or less conjugate diameter, is an operation of extreme difficulty, lengthy, requiring a very great experience, as far as the mother is concerned, requiring an amount of manual dexterity rarely to be acquired outside of a large city. While, on the other hand, the Cesarean section is an easy operation, capable of successful performance by any surgeon of ordinary skill.'

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