consideration. We have seen that the infant, a true human being, has a right to live, as well as its mother. “All men are created equal, and have an equal right to life,” declares the first principle of our liberty. The Creator, too, as reason teaches, has a clear right to the child’s life; that child may answer a very special purpose of Providence. But whether it will or not, God is the supreme and the only Master of life and death, and He has laid down the strict prohibition, “Thou shalt not kill.”

Now comes the plea of self-defence against an unjust aggressor. If the child is such, if it unjustly attacks its mother’s life, then she can destroy it to save herself, and her physician can aid the innocent against the guilty party. But can it be proved that the infant is an unjust aggressor in the case? There can be no intentional or formal guilt in the little innocent babe. But can we argue that the actual situation of the child is an unjust act, unconsciously done, yet materially unjust, unlawful? Thus, if a madman would rush at me with a sharp sword, evidently intent on killing me, he may be called an unjust aggressor; though, being a raving maniac, he does not know what crime he is committing, and is formally innocent of murderous intent. Materially considered, the act is unjust, and I can defend myself lawfully as against any other unjust assailant. Such is the common teaching of moralists. But can the innocent babe be classed in the same category with the raving maniac? Why should it? It is doing nothing; it is merely passive in the whole process of parturition.

Will any one object that the infant has no right to be there at all? Who put it there? The only human agents in the matter were its parents. The mother is more accountable for the unfortunate situation than the child. Certainly you could not, to save the child, directly kill the mother, treating her as an unjust assailant of her child’s life? Still less can you treat the infant as an unjust assailant of its mother’s life.

The plea of self-defence against unjust aggression being thus ruled out of court in all such cases, and no other plea remaining for the craniotomist, we have established, on the clearest principles of Ethics and Jurisprudence, that it is never allowed directly to kill a child as a means to save its mother’s life. It would be a bad means, morally evil; and no moral evil can ever be done that good may come of it; the end cannot justify an evil means. In theory all good men agree with us that the end can never justify the means. But in practice it seems to be different with some of the medical profession. Of late, however, the practice of craniotomy and all equivalent operations upon living subjects has gone almost entirely out of fashion among the better class of physicians.

Allow me, gentlemen, to conclude this lecture with the reading of two extracts from articles of medical writers on the present state of craniotomy in their profession. You will find them in accord with the conclusions at which we have arrived by reasoning upon the principles of Jurisprudence.

Dr. W. H. Parish writes (“Am. Eccles. Review,” November, 1893, p. 364): “The operations of craniotomy and embryotomy are to-day of relatively infrequent occurrence, and many obstetricians of large experience have never performed them. Advanced obstetricians advocate the performance of the Cesarian section or its modification—the Porro operation—in preference to craniotomy, because nearly all the children are saved, and the unavoidable mortality among mothers is not much higher than that which attends craniotomy. Of one hundred women on whom Cesarian section is performed under favorable conditions and with attainable skill, about ninety-five mothers should recover and fully the same number of children. Of one hundred craniotomies, ninety-five mothers or possibly a larger number will recover, and of course none of the children. The problem resolves itself into this: Which shall we choose—Cesarian section with one hundred and ninety living beings as the result, or craniotomy with about ninety-five living beings?”

Even if a liberal deduction be made for unfavorable circumstances and deficient skill, the results, gentlemen, will still leave a wide margin in favor of Cesarian section. My second extract is from an article of Dr. M. O’Hara, and it is supported by the very highest authorities (ib. p. 361): “Recently [August 1, 1893] the British Medical Association, the most authoritative medical body in Great Britain, at its sixty-first annual meeting, held at Newcastle-upon-Tyne, definitely discussed the subject before us. In the address delivered at the opening of the section of Obstetric Medicine and Gynecology, an assertion was put forth which I regard as very remarkable, my recollection not taking in any similar pronouncement made in any like representative medical body. The authoritative value of this statement, accepted as undisputed by the members of the association, which counts about fifteen thousand practitioners, need not be emphasized.

“Dr. James Murphy (‘British Medical Journal,’ August 26, 1893), of the University of Durham, made the presidential address. He first alluded to the perfection to which the forceps had reached for pelves narrowed at the brim, and the means of correcting faulty position of the fœtus during labor. He then stated: ‘In cases of great deformity of the pelvis, it has long been the ambition of the obstetrician, where it has been impossible to deliver a living child per vias naturales, to find some means by which that child could be born alive with comparative safety to the mother; and that time has now arrived. It is not for me to decide,’ he says, ‘whether the modern Cesarian section, Porro’s operation, symphysiotomy, ischiopubotomy, or other operation is the safest or most suitable, nor yet is there sufficient material for this question to be decided; but when such splendid and successful results have been achieved by Porro, Leopold, Saenger, and by our own Murdoch Cameron, I say it deliberately and with whatever authority I possess, and I urge it with all the force I can master, that we are not now justified in destroying a living child; and while there may be some things I look back upon with pleasure in my professional career, that which gives me the greatest satisfaction is that I have never done a craniotomy on a living child.’”

You will please notice, gentlemen, that when this distinguished Doctor said, “We are not now justified in destroying a living child,” he was speaking from a medical standpoint, and meant to say that such destruction is now scientifically unjustifiable, is a blunder in surgery. From a moral point of view it is not only now, but it was always, unjustifiable to slay a child as a means to save the mother’s life; a good end cannot justify an evil means, is a truth that cannot be too emphatically inculcated. This is one of the most important subjects on which Medical Jurisprudence has been improved, and most of its text-books are deficient. The improvement is explained with much scientific detail in an address of the President, Samuel C. Busey, M.D., before the Washington Obstetrical and Gynecological Society (“Am. Journal of Obstetrics and Diseases of Women and Children,” vol. xvii. n. 2).