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THE SURGICAL SOLUTION: THE WRITINGS OF ACTIVIST PHYSICIANS IN THE EARLY DAYS OF EUGENICAL STERILIZATION PHIUP REILLY* The earliest American case report of a vasectomy was published by Albert John Ochsner in 1899 [I]. Dr. Ochsner, just starting his long tenure as chiefsurgeon at Saint Mary's Hospital and Augustana Hospital in Chicago, described two patients who had consulted him because of prostate problems in the summer of 1897. The. first patient, who had been bothered by prostatitis for 3 months, was much improved 2 weeks after the vasectomy. At follow-up 20 months later, the patient reported that his "sexual power," which had been somewhat impaired before the operation, was "as good as at any time during his life." Ochsner reported similar positive results with his second patient. What is so unusual about an article reporting the technical aspects ofa new operation and its application to two patients? Of course, today we know that there is no physiological basis to suppose that severing the vasa should cure prostate disease. But what is most interesting is the manner in which the young surgeon chose to cast the result of his therapeutic trial. Consider the title: "Surgical Treatment of Habitual Criminals." Immediately after describing his cases, Ochsner reiterated a widely held thesis: "It has been demonstrated beyond a doubt that a very large proportion of all criminals, degenerates and perverts have come from parents similarly afflicted. It has also been shown, especially by Lombroso, that there are certain inherited anatomic defects which characterize criminals, so that there are undoubtedly born criminals." He then argued that "ifit were possible to eliminate all habitual criminals from the possibility of having children, there would soon be a very marked decrease in this class." Dr. Ochsner claimed that the vasectomy * Associate professor of law and director, Institute for the Interprofessional Study of Health Law, University of Houston Law Center, Houston, Texas 77004.© 1983 by The University of Chicago. All rights reserved. 003l-5982/83/26O4-0362$01.00 Perspectives in Biology and Medicine, 26, 4 · Summer 1983 | 637 offered a socially acceptable method of doing away with hereditary criminals from the "father's side," and that the same treatment "could reasonably be suggested for chronic inebriates, imbeciles, perverts and paupers." In a page of printed text, Ochsner articulated a deceptively simple solution to a social problem, the rising tide of"racial degeneracy," that had become a major issue in America during the last quarter of the nineteenth century. Ochsner's paper was his first and last published contribution to the problem of "hereditary degeneracy." In 1900 he was appointed professor of clinical surgery at the University of Illinois, a post he held until just prior to his death in 1926. During his rich career, he published four books (including a text on thyroid surgery) and served as president of the American College of Surgeons. Although he did not champion the cause of eugenical sterilization, he might well have influenced several prominent Chicago surgeons who a decade later became vocal advocates of this practice. Before investigating the important role played by these and other physicians in the development of a policy of eugenical sterilization , I shall briefly review the social concerns that fostered this policy. Pre-Mendelian Studies ofHeredity Although the rediscovery of Mendel's experiments in 1900 was a crucial event for the study of human heredity, that science was already well established at the close of the nineteenth century. In 1859 The Origins of Species cracked the bulwark of resistance to a biological view of man. In both Europe and the United States, many people who could not accept consanguinity with the great apes were drawn to biological studies for another reason: they wanted proof that white races were superior to black races. The publication by Arthur de Gobineau of his influential work, Essai sur l'inégalité des races humaines (1855), had "proved" that there were "higher" and "lower" races. In 1856, Dr.Josiah Clark Nott, a physician from Mobile, Alabama, and a young Swiss immigrant named Henry Hotz translated Gobineau's work, edited to strengthen the idea of racial inequality, and dedicated it "to the Statesman of America" [2]. The scientific study...


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