The fact that castration can no longer be properly considered a punishment, is shown by the possibility of deliberately seeking the operation simply for the sake of convenience, as a preferable and most effective substitute for the adoption of preventive methods in sexual intercourse. I am only at present acquainted with one case in which this course has been adopted. This subject is a medical man (of Puritan New England ancestry) with whose sexual history, which is quite normal, I have been acquainted for a long time past. His present age is thirty-nine. A few years since, having a sufficiently large family, he adopted preventive methods of intercourse. The subsequent events I narrate in his own words: "The trouble, forethought, etc., rendered necessary by preventive measures, grew more and more irksome to me as the years passed by, and finally, I laid the matter before another physician, and on his assurances, and after mature deliberation with my wife, was operated on some time since, and rendered sterile by having the vas deferens on each side exposed through a slit in the scrotum, then tied in two places with silk and severed between the ligatures. This was done under cocaine infiltrative anæsthesia, and was not so extremely painful, though what pain there was (dragging the cord out through the slit, etc.) seemed very hard to endure. I was not out of my office a single day, nor seriously disturbed in any way. In six days all stitches in the scrotum were removed, and in three weeks I abandoned the suspensory bandage that had been rendered necessary by the extreme sensitiveness of the testicles and cord.
"The operation has proved a most complete success in every way. Sexual functions are absolutely unaffected in any way whatsoever. There is no sense of discomfort or uneasiness in the sexual tract, and what seems strangest of all to me, is the fact that the semen, so far as one can judge by ordinary means of observation, is undiminished in quantity and unchanged in character. (Of course, the microscope would reveal its fatal lack.)
"My wife is delighted at having fear banished from our love, and, taken all in all, it certainly seems as if life would mean more to us both. Incidentally, the health of both of us seems better than usual, particularly so in my wife's case, and this she attributes to a soothing influence that is attained by allowing the seminal fluid to be deposited in a perfectly normal manner, and remain in contact with the vaginal secretions until it naturally passes off.
"This operation being comparatively new, and, as yet, not often done on others than the insane, criminal, etc., I thought it might be of interest to you. If I shed even the faintest ray of light on this greatest of all human problems ... I shall be glad indeed."
Such a case, with its so far satisfactory issue, certainly deserves to be placed on record, though it may well be that at present it will not be widely imitated.
The earliest advocacy of castration, which I have met with as a part of negative eugenics, for the specific "purpose of prophylaxis as applied to race improvement and the protection of society," is by Dr. F. E. Daniel, of Texas, and dates from 1893.[[447]] Daniel mixed up, however, somewhat inextricably, castration as a method of purifying the race, a method which can be carried out with the concurrence of the individual operated on, with castration as a punishment, to be inflicted for rape, sodomy, bestiality, pederasty and even habitual masturbation, the method of its performance, moreover, to be the extremely barbarous and primitive method of total ablation of the sexual organs. In more recent years somewhat more equitable, practical, and scientific methods of castration have been advocated, not involving the removal of the sexual glands or organs, and not as a punishment, but simply for the sake of protecting the community and the race from the burden of probably unproductive and possibly dangerous members. Näcke has, from 1899 onwards, repeatedly urged the social advantages of this measure.[[448]] The propagation of the inferior elements of society, Näcke insists, brings unhappiness into the family and is a source of great expense to the State. He regards castration as the only effective method of prevention, and concludes that it is, therefore, our duty to adopt it, just as we have adopted vaccination, taking care to secure the consent of the subject himself or his guardian, of the civil authorities, and, if necessary, of a committee of experts. Professor Angelo Zuccarelli of Naples has also, from 1899 onwards, emphasized the importance of castration in the sterilization of the epileptic, the insane of various classes, the alcoholic, the tuberculous, and instinctive criminals, the choice of cases for operation to be made by a commission of experts who would examine school-children, candidates for public employments, or persons about to marry.[[449]] This movement rapidly gained ground, and in 1905 at the annual meeting of Swiss alienists it was unanimously agreed that the sterilization of the insane is desirable, and that it is necessary that the question should be legally regulated. It is in Switzerland, indeed, that the first steps have been taken in Europe to carry out castration as a measure of social prophylaxis. The sixteenth yearly report (1907) of the Cantonal asylum at Wil describes four cases of castration, two in men and two in women, performed—with the permission of the patients and the civil authorities—for social reasons; both women had previously had illegitimate children who were a burden on the community, and all four patients were sexually abnormal; the operation enabled the patients to be liberated and to work, and the results were considered in every respect satisfactory to all concerned.[[450]]
The introduction of castration as a method of negative eugenics has been facilitated by the use of new methods of performing it without risk, and without actual removal of the testes or ovaries. For men, there is the simple method of vasectomy, as recommended by Näcke and many others. For women, there is the corresponding, and almost equally simple and harmless method of Kehrer, by section and ligation of the Fallopian tubes through the vagina, as recommended by Kisch, or Rose's very similar procedure, easily carried out in a few minutes by an experienced hand, as recommended by Zuccarelli.
It has been found that repeated exposure to the X-rays produces sterility in both sexes, alike in animals and men, and X-ray workers have to adopt various precautions to avoid suffering from this effect. It has been suggested that the application of the X-rays would be a good substitute for castration; it appears that the effects of the application are only likely to last a few years, which, in some doubtful cases, might be an advantage. (See British Medical Journal, Aug. 13, 1904; ib., March 11, 1905; ib., July 6, 1907.)
It is scarcely possible, it seems to me, to view castration as a method of negative eugenics with great enthusiasm. The recklessness, moreover, with which it is sometimes proposed to apply it by law—owing no doubt to the fact that it is not so obviously repulsive as the less radical procedure of abortion—ought to render us very cautious. We must, too, dismiss the idea of castration as a punishment; as such it is not merely barbarous but degrading and is unlikely to have a beneficial effect. As a method of negative eugenics it should never be carried out except with the subject's consent. The fact that in some cases it might be necessary to enforce seclusion in the absence of castration would doubtless be a fact exerting influence in favor of such consent; but the consent is essential if the subject of the operation is to be safeguarded from degradation. A man who has been degraded and embittered by an enforced castration might not be dangerous to posterity, but might very easily become a dangerous member of the society in which he actually lived. With due precautions and safeguards, castration may doubtless play a certain part in the elevation and improvement of the race.[[451]]
The methods we have been considering, in so far as they limit the procreative powers of the less healthy and efficient stocks in a community, are methods of eugenics. It must not, however, be supposed that they are the whole of eugenics, or indeed that they are in any way essential to a eugenic scheme. Eugenics is concerned with the whole of the agencies which elevate and improve the human breed; abortion and castration are methods which may be used to this end, but they are not methods of which everyone approves, nor is it always clear that the ends they effect would not better be attained by other methods; in any case they are methods of negative eugenics. There remains the field of positive eugenics, which is concerned, not with the elimination of the inferior stocks but with ascertaining which are the superior stocks and with furthering their procreative power.