Holmes, one of the first in Chicago to try the newly revived method, says[215] that in July, 1914, before the great war broke out, there were twenty-five malpractice suits pending in one German city as a result of the morphine-scopolamine fad. He quotes a noted obstetrician on this subject: "If you will use the method, have the patient in the best hospital possible, with all the appurtenances requisite for the revival of the child; if you do not know, learn at once the differences between asphyxia, oligoapneia, and narcotic poisoning, and the methods of treating them; get the best and the most reliable product called scopolamine; and then be sure you are in a position to be adequately defended by a lawyer versed in malpractice suits."
This is the state of the question. Two or three men in the best circumstances say they get one hundred perfect results; other men, equally or far more skilled and in equally favorable circumstances, get one hundred results which are anything but successful, often a disgrace to science, and undoubtedly immoral. They are immoral because they risk human life in an attempt to ease a physiological pain, and this is not a sufficient reason; moreover, these attempts fail oftener than they succeed. The second group of practitioners have no motive except honesty to induce them to make their unfavorable reports of failure. The reports of the two groups are directly contradictory, and the judgment is thus a matter of motives. Testimony from women who have gone through the process is not to be taken into account. They were dazed, and in any case they are not competent to judge a matter which is wholly technical.
We know the limitation of morphine and scopolamine and we cannot improve their use. If enough is given to still pain, we take a criminal risk; if we do not give enough to remove the sense of pain, why not use the safer nitrous oxide, ether, and chloroform? If enough morphine and scopolamine are administered early in labor to a multipara, the labor is commonly stopped; if this dosage is given after the pains are developed, the baby is born, as a rule, before they take effect.
[CHAPTER XXIII]
Vasectomy, or Sterilization, by State Law
The State of Indiana in 1907 enacted a vasectomy law which obliges the superintendents of some prisons and asylums to appoint two surgeons whose office is to sterilize sexually criminals, idiots, imbeciles, and similar persons, if these surgeons, in consultation with the chief physician of the institution, deem the propagation of children by such so-called degenerates detrimental to society. The same law has been incorporated in the statutes by New York, New Jersey, Washington, Iowa, Nevada, Wisconsin, Connecticut, California, Utah, Kansas, Oregon, and Minnesota. The law has been proposed several times in the Legislature of Pennsylvania, but it was vetoed twice and held up once in the Assembly.
In New Jersey there was question of sterilizing an epileptic girl, and the Supreme Court of that State[216] decided in 1913 that the law is contrary to the State and Federal constitutions. In 1916 Probate Judge Lapeer of Michigan declared the law as passed in his State in 1913 unconstitutional, but the State appealed against this decision. The Supreme Court of Washington[217] decided in favor of the law in a case where a man convicted of rape was sentenced by the trial judge to life imprisonment and to vasectomy as a punishment. The constitutionality of the Iowa law is on appeal to the United States Supreme Court after a Federal judge had declared it unconstitutional. The law in Indiana was put into effect in hundreds of cases, but Governor Marshall set the law in abeyance. Two Federal judges in Kansas said the law is unconstitutional and granted an injunction against its application in a particular case. In 1808 the superintendent of a Kansan institution for the feeble-minded castrated forty-eight boys. Up to April, 1916, about twenty-five feeble-minded boys in the Wisconsin institution at Chippewa Falls were sterilized, and the authorities then said they intended to sterilize the girls. The law has been advocated by alienists in Switzerland, and French and English physicians have advocated it.
The reason given by the advocates of this law is the alarming prevalence of feeble-mindedness with its tendency to criminality; and as, they say, heredity accounts for 65 per cent. of feeble-mindedness, the feeble-minded should be prevented from propagating their kind. Sweden, with 5,500,000 inhabitants, has 18,000 insane, 14,000 idiots, 20,000 imbeciles, and 7,000 epileptics. Much of this degeneracy is due to the notorious alcoholism of the Swedes, which only lately has been brought under some control. Pennsylvania had about 17,000 feeble-minded in 1913. In a single county almshouse in that State were 105 women who had given birth to 101 defective children. One feeble-minded couple in the same State had 19 defective children; two other families had 9 imbeciles and 7 idiots. In New Jersey the history of 480 individuals of the famous "Kallikak" family (a pseudonym), descended from a feeble-minded woman who lived at the time of the Revolutionary War, has been traced out, and of these descendants only 40 were normal. New York State has 32,000 known feeble-minded persons. One State school for the feeble-minded in Indiana in 1908 had 1054 inmates. There are 6000 mentally defective children in the schools of Chicago. An investigation made in Illinois about 1907 brought out the conclusion that all the defectives and delinquents in that State at the time could be traced to 150 families. Poehlmann of Bonn traced the descendants of one female drunkard through six generations in 800 individuals, and of these 107 were illegitimate, 102 were beggars, 181 were prostitutes, 76 were criminals in a grave degree, 7 were murderers, and they had cost the State $1,206,000. The Jukes sisters, two illegitimate prostitutes in New York State, in five generations bred 709 criminals. Fifty-two per cent. of the women were prostitutes, whereas the ordinary ratio of prostitutes to other women is 1.66 per cent. Alcoholics engender degenerates. In three generations of 215 French alcoholic families, Legrand found that 60 per cent. of the children were degenerates. Bourneville found that 62 per cent. of 1000 idiotic, epileptic, and feeble-minded children in Paris had alcoholic parents.