for 10 years under treatment in the Asile Sainte-Anne, for chronic maniacal excitation. During the whole night she pronounces unintelligible monologues. On the 17th of December, at 5.30 P. M., we gave 1 gramme of Sulfonal in soup. She went to bed at 7 o'clock; at 8, that is to say, 24 hours after the ingestion of the medicament, we found her in a profound sleep. We saw her at 10, 12.30 and 3.30 and found that the sleep was uninterrupted; it continued until 5 A. M. We found no modification of color, pulse or temperature. We continued to give Sulfonal in this dose, at intervals of 3 days, with the same results; no other hypnotic was used. When we suspended the use of the medicament the habitual insomnia returned. The urine presented no modification worthy of note.

CASE IX.

Catherine M., æt. 56; has been suffering for fifteen years from maniacal excitation, with hallucinations of hearing; she also has ideas of persecution. She is troubled with an insomnia which cannot be combated with less than 3-grain doses of chloral. Arterio-sclerosis very pronounced; volume of the heart slightly augmented. On the 19th of December we gave 1 gramme of Sulfonal at 6 P. M. She slept at 9 for two hours. On the 20th we gave 2 grammes of Sulfonal; she slept at 9 and her sleep lasted for 7 hours. On December 21st we gave 11 grammes of Sulfonal; she went to sleep two hours afterward and slept uninterruptedly for 8 hours. No nausea or vomiting; appetite good. We gave these 14-gramme doses 10 times, and always with favorable results, as favorable, at least, as we could get with 3 grammes of chloral.

CASE X.

Emily P., æt. 34 years; suffers from chronic maniacal excitation with disordered ideas and actions; she tears her clothing and sings and cries during the night. At the age of 26 she had crises resembling those of hystero-epilepsy.

Her maternal great-uncle died insane. We had been treating her insomnia with chloral in 3-gramme doses. On the 18th of December we gave her 1 gramme of Sulfonal at 6 P. M. She slept 3 hours afterward, the sleep lasting for 2 hours. On the following night we gave 2 grammes of Sulfonal which induced a sleep lasting for 54 hours. No abnormal phenomena. On January 12th we gave 3 grammes of Sulfonal which induced a sleep of 9 hours. On the 18th 2 grammes of Sulfonal gave 4 hours sleep.

CASE XI.

Marie P., æt. 48 years, has been under treatment at the Sainte-Anne Asylum for 6 years. Very marked arterio-sclerosis. She has dyspeptic troubles which have long been proportioned to the amount of chloral she has absorbed with a view to combating insomnia. The dose given in this case was never less than 3 grammes. For two weeks we gave 1 grammes of Sulfonal every other day. Sleep came on later than with chloral, but it lasted longer, that is to say, for 7 to 9 hours, and was accompanied by no vaso-motor phenomena; after a week's treatment with Sulfonal the patient's appetite was found to be improved and she complained no more of pain in the left hypogastrium.

varied from 25 centigrammes to 5 grammes. In almost all cases we gave the medicament in one dose, having used fractional doses (25 centigrammes) in only 2 cases. We gave in all 275 doses, and these were followed by sleep in 263 instances. The cases in which the use of Sulfonal was not followed by a soporific effect were: One of multiple fracture; one of chronic mania; one of general paralysis, and one of cerebral apoplexy.

*Sulfonal, in doses of 75 centigrammes to 3 grammes, generally determined, in 2 to 4 hours, 4 to 9 hours of sleep.

In doses of 75 centigrammes to 3 grammes, according to individual indications, Sulfonal appears to us to be most useful for the purpose of combating insomnia in the majority of mental maladies.

We believe it to be a good plan to avoid giving large doses of Sulfonal two days in succession. It is better to give a full dose on the first day, and quarter doses on the following days, in the method adopted by Professor Mairet.

:0:

Inter

ruptions occurred only in one case of general paralysis; one of cerebral apoplexy, and one of hysteria with delirium.

Apart from the incontestable somniferous action of Sulfonal, it lessened maniacal excitement.

Sulfonal manifested its action for several days following the administration of full doses. In one case only was the suppression of the medicament followed by an immediate return of insomnia.

It was observed that the use of the medicament may be suspended at the will of the physician; it creates no drug habit.

Sulfonal possesses not only the property of inducing sleep, but it concurs toward the reëstablishment of normal sleep.

The gastro-intestinal apparatus was rarely disturbed during our experiments with Sulfonal, and when nausea did occur it was under too elevated doses, that is to say, with doses exceeding 3 grammes.

In Case XI. we obtained a sensible amelioration of the condition of the digestive tract by replacing chloral with Sulfonal.

We concluded that the best mode of giving Sulfonal was in one or two glasses of soup or herb tea, just before suppertime.

*The words were italicised by the author.-Tran.

CONCEPTION UNDER ANY

CIRCUMSTANCE?

G. E. LEMMER, M. D., DANBURY, CONN.

LLOW me to quote Dr. E. C. Fras

AL

er's letter under the above heading, from your last issue. "Married women who are averse to having any more children will consult a doctor; if he gives them no encouragement they will go to some quack who will endeavor to impart the desired information. Are not preventives less damaging and demoralizing than abortions? Is the physician, under any circumstances, justifiable in suggesting preventives? If so, what ones are the best (medicinal )?"

In response to the most salient point in the above letter, I give as my belief that no circumstance nor combination of surroundings, can ever justify the act in question. Inasmuch as the doctor's letter refers to the moral element of the act most particularly, it becomes pertinent to inquire, at what time following the ejaculation of healthly semen within the female genital tract, the physician's interference may result in actual murder or murder by intention, for I hold that any means, resorted to either during coitus or immediately following, whereby the union of the spermatozoa and ovum is prevented-whether by withdrawal-cold douching, or any mechanical or medicinal means, may properly

be classed as "Onanism," and therefore "murder by intention," since they all alike tend to prevent that material union, the result of which would have been the conception of an immortal human life. And I hold also that, divested of all sophistry the destruction of an impregnated ovum is child murder as perfect as though a full term child be strangled at birth. The fact that a few weeks foetus bears no physical resemblance to the nine-months child does not alter the nature of the act, for the reason that the dividing line, as between a human being and a lesser order of creation, depends not so much on material form as on the possession of that proof of human life-a soul-the external evidence of whose presence we see in the three attributes: free will power, memory and understanding. The fact of these attributes remaining dormant during intra-uterine life by no means militates against their actual presence.

This brings up the query; at what time following the proto-plastic union of sexual cell life, does actual human life begin? I maintain this

miraculous

change occurs at the time the spermatozoa having penetrated the vitelline membrane, dissolve in the fluid vitellus, and giving up their individual cell life, become incorporated into one with the ovum. The period required for this transformation following the contact of semen and ovum, taking as a criterion experiments of the lower animals, will be about three hours. According to Robin the undulatory motion of the spermatozoa begins to grow perceptibly slower within fifteen minutes after entering the vitellus, and has entirely ceased in two hours following; at which time a comparative recount of the number of spermatozoa floating within the vitellus proves their original number diminished, the missing ones. having fused their cell live into the substance of the limpid vitellus.

The time required for this change following healthy coitus, will depend on the vigor of individual sexual cell life

in both parties and on the position of the ripened ovum within the female genital track. Allowing for the rupture of a Graafian follicle at the time of coitus, and with a perfect ejaculation at the congested os, conception may and probably will follow within a few hours; the female parts being normal. Given the extreme distance from the os to the ruptured follicle, as seven and a half inches in the woman who has borne child, and six in the virgin, and taking as authority Henle who gives the forward movements of the spermatozoa as one inch in seven and half minutes, we find that four hours after coitus, would be ample time for the spermatozoa to have traveled the entire length of the generative tract, and having penetrated the ovum, dissolved itself within the vitellus; and this without the ovum having been moved towards the uterus by the ciliated epithelium of the Fallopian tube, which ever present motion would still further precipitate impregnation. So that it becomes, not a possibility, but a strong probability that impregnation of the ovum occurs within two hours, and not beyond four hours following perfect coitus.

Again, extra-ovarian life of the ripened ovum will last for a period of about nine days following the rupture of a Graafian follicle, and before being vivified by the semen; therefore a single act of coitus during this time may result in pregnancy. And now, allowing for sexual intercourse to have occurred a week and a half before the woman's time of ovulation, conception is likely to follow, since Luschke has found that the spermatozoa possess life and vigorous motion for ten days after ejaculation within the female genital tract, their power of fecundating lasting as long as that of motions.

From these figures it follows that from ten days preceding to the ninth following ovulation the chances-other things being equal-are in favor of speedy conception. As few women will seek for help earlier than twenty-four hours fol

ence.

lowing exposure, and the large majority not before the cessation of the subsequent menses gives warning, it appears to me reasonable, to assume that the so called medicinal preventives usually come too late to prevent, and if they accomplish anything, it is the destruction of an impregnated ovum. The only certain safeguard against conception during these days at least, is by mechanical interferOf the remaining ten or twelve days of each month one half may justly be classed as dangerous in the event of exposure, since it is by no means proven that extra-ovarian life of the ripened ovum begins in all cases with the menstrual discharge. Lusk says there is no time during the years of active sexual life that a woman may expose herself with out danger of impregnation, which remark it seems to me covers the remaining few days of our month. The doctor refers, as a possible justification of the preventive act to those ever present, and sometimes pathetic appeals of married women—have had family enough-the dread of another labor-a worthless drunken husband-poverty, etc. All of which pleas I could understand only by regarding marriage and its results from an atheistic stand-point and looking on the object of man's existence, as being consummated this side the grave. Nor is there wanting in condemnation of this unnatural act the philosophy of the best of Pagan minds.

In no age has suffering the most intense with death as an accompaniment, been sufficient--in itself--to cause the Author of all to stay the workings of any one of nature's laws; the rail-way train loaded with priceless human lives plunges into an open draw-the law of gravity in obedience to which it carries its living freight down to death, could easily have been suspended by the same power that brought it into force. A crowded tenement on fire-the law of combustion dooming some among its inmates to an agonizing death could without effort have been rendered inert by the power that

made it-but nature's laws are held inviolable by their Author-and justly so, for otherwise by what would we be guided in our daily reckonings-everything would return to primeval chaos.

In the act of marriage woman knows full well that she obligates herself primarily to the bringing forth of her kind, and this obligation, with all its attending pains and dangers she assumes voluntarily; by what process of reasoning then does she justify her plea to have the sequence of her voluntary act nullified, and by what authority does the physician arrogate to himself the right to interfere in this nature's most subtle and grandest law-the reproduction of the human species? And the question seems the more absurd when this sacrilege on God's handiwork is performed that the woman may except not death by water or fire but the brief pains of labor and what to the true woman would be a joy most exalted-the rearing of her offspring. In those truly distressing, cases in which a former child was of necessity delivered by cæsarean section, laparotomy, or by that repulsive form of infanticide, craniotomy, my sense of duty would end in giving what comfort possible in the assurance, that through living remote ample time would be had to remove to some lying-in hospital where proper surgical skill would be had for the performance of abdominal section should it be requisite.

Another class that appeals strongly to the physician's sympathies are those clean women who become pregnant by a syphilitic husband, or who during the initial sore become directly inoculated by him; with a pregnancy liable to follow. Pertinent to this point, that man should be held guilty of a crime against nature and society who having contracted syphilis marries without the consent of his physician, and the latter to my mind should obligate his patient to a continuous treatment extending two years or over, dating from the appearance of secondary symptoms. The tuberculous

man or he in whose family runs a clear taint of insanity commits a grave error in marrying, but nevertheless the fact that these violations of nature's harmony occur, does not justify the avoiding of their results by the commission of a yet greater crime.

The doctor asks "are not preventives less damaging and demoralizing than abortions?" I should say yes, only in so far as physical sensations go-because of the pain, sight of blood, etc., but as regards the morale, I think the effect would be about equal, since both alike tend to equal results, the destruction of what would have eventuated in a human life; true, it does not follow that a woman must become pregnant as a result of coitus, nor that an impregnated ovum must of necessity result in a perfect child; first in one or both parties some essential element may be wanting, or following conception abortion may happen, the result of syphilis, malarial poison, accident,or due to mal-nutrition or defective cell growth, a mole or non-human monstrosity may result, yet, were I to interfere in the sense of this paper I should be held guilty in the one case of Onanism by direct complicity and in the other event of actual child murder; the law being imperative that I should regard the product of human sexual intercourse as human, so long as there is wanting absolute proof to the contrary. The fact that pregnancy might not have resulted and, if it had, might from other causes have aborted, does not diminish the shock to the woman's morale nor palliate even to her mind the physician's guilt.

The doctor's object and intention having been in the one case the teaching or assisting in the consummation of some variety of Onan's unnatural act, and in the other his deliberate employment of means known to be destructive to embryonic life, makes his moral degradation to my way of reasoning full as great as though his work bore its fruit of death, inasmuch as the Author of all laws adjudges man innocent or guilty

not so much by his acts as by the intention, therein.

Patients of this class as the doctor says, will drift into the hands of the charlatan, should the physician refusewell, should they threaten as did an unmarried woman in my office a short time since, to go and drown herself, it should be no more an incentive to the doctor's complying, than were the woman to ask for a fatal dose of morphine under the threat of dying somemore violent death in the event of refusal.

As pertaining to the above point I would like a moment's digression. It is the custom among many of the profession in the case, especially of unmarried women to resort to an unmanly deception in regard to treatment, giving as a justification the most untenable premise that "I prevented her having an abortion performed." A young woman will give history of recent exposure, with no sign of following menses; the physician gives her his unqualified assurance that he can and will bring her "round allright"-so he does, but not in the sense the unfortunate girl was deceived into anticipating and not in the sense she had a right to expect. Having written her a prescription potent neither for good or evil results, he takes her money, bows her out with the injunction to call in a weeks time. Having been kept. along in this placid gait for six or seven morths she becomes suddenly very much awake to the double fact that she is soon to become a mother beyond any shadow of doubt, and that her physican in whom she so implicitly trusted, is either a liar or an ass. No amount of possible good to result can justify a deliberate lie, as no man has the right to do evil that good may follow; that woman's Creator would. not assume, against her will to think and act for her, since in sin or virtue her free will, with all that this implies, belongs to her alone. The average physician will find equally with his patients, enough to do in directing his own moral life in.