no foundation. It does not degrade the medical attendant any more to have a stipulated price placed upon his annual services in a family before than after that service is rendered. The "time-honored and respected honorarium," so sacred to many, has equal value in both cases. Besides, how frequently does the physician stipulate to attend infirmaries, dispensaries, manufactories, and life insurances for fixed annual salaries. In these instances, so common in the profession of every town, the contract plan is adopted without even the thought of professional degradation. The allegation that it would lead to overwork would not prove true if the contract exempted, as it ought, all special attendance, as at night, in cases of accident, etc. The arguments in favor of the contract plan are plausible, and deserve to be well weighed. It secures the payment of the services of the physician much more certainly than the fee system. In a far less number of instances we are assured, is the payment withheld under the former than under the latter system. The obligation of the patient may not be any greater morally under one than under the other, but legally he is bound by the contract to make prompt payment. The freedom of the physician to visit the family and prolong his attendance upon the sick is secured by the contract. His visits are not carefully noted, nor is it even intimated to him that his services are not required in a case of convales

cence. But, perhaps, the strongest argument that can be adduced in favor of the contract is, that the physician assumes under it the highest and most dignified functions of his profession. His aim now is to prevent disease; he is now not always called to cure the sick, but he has a higher duty, viz., that of preserving the health. He visits his families as a hygienist; he attends carefully to the conditions which surround the family circle, and corrects any tendency to disease. The dwelling is often examined, and proper ventilation, drainage, etc., secured; the foods are inquired into, and those selected adapted to each member of the family; the clothing is inspected, the right material advised, and the proper style directed. In a word, the physician becomes a house-to-house visitant, advising and directing in all matters pertaining to the health of the occupants. It can not be doubted that were this system generally adopted the sum of sickness and mortality would be greatly diminished. The details of the contract plan are made up by the parties themselves. The special sum stipulated must depend upon the size of the family, and the conditions peculiar to each. But there is no reason for making the price less than the sum total of annual fees under the present system. The contract plan has already been adopted by some practitioners among us, and is generally highly approved. If universally approved, it may prove to be a most beneficial medical reform.

XL.

CRIME OF ABORTION.

T

HE appearance in the courts of two abortionists within a short period, to answer to the charge of homicide, and the introduction of a more stringent Act against this crime into the Legislature of New York, are suggestive of the query-" How far does this evil exist at present in American communities, and what is the popular opinion in regard to this crime?" If viewed in the light of an ancient civilization, the question would seem to have some pertinency, but it appears the most obvious anachronism to canvass the frequency of this crime, and the state of popular opinion in regard to it, in a Christian community. Nevertheless, the fact of the existence of abortion as a common and even increasing evil, appears in our mortality records; and the evidences that the public do not look upon it as a flagrant crime, and regard its abettors as criminals, become painfully apparent when the horrible developments of murder, by the imfamous acts of abortionists, are revealed. The proportion of still-births to the living gives the only basis on which can be calculated the number of cases of abortion. These figures are,

however, but approximative, for very many cases of still-birth are not produced abortions, while a vast number obviously escape detection and registration. Taking our mortality reports with all due allowance for these discrepancies, the record is still sufficiently humiliating. From these, it appears, that since the first registry in New York, in 1805, the proportionate and actual increase of still-births has been alarmingly rapid. In 1805, the ratio of foetal deaths to the population was 1 to 1,633, but in 1849, 1 to 340. In 1856, the records show that 1 in every 11 is still-born in this city, while the reports of European countries, even allowing for criminal abortions, give the proportion of still-births at 1 in 15. Accurate records of the best practitioners give, as the ratio of premature births, or non-viable fœtuses, to the whole number of births, which includes, of course, only abortions from natural or accidental causes, 1 to 78; but in New York the ratio of the same births to the whole number is 1 to 40. The ratio of premature still-births at full time in this city, in 1846, was 1 in 10, and in 1856, ten years later, it had increased to 1 in 4. In 1868-71, it appears that the still-births amounted to upward of 8 per cent. of the total mortality. From these facts it is apparent, not only that produced abortions are frequent in this community, but that they are rapidly increasing. In seven years, from 1850 to 1857, the still-births doubled, and we have good evidence that since

that period the proportion has rapidly increased. New York may justly be taken as an index of this country. It certainly does not give an exaggerated representation. The registration returns of the State of Massachusetts show that the comparative frequency of abortions in that State is thirteen times as great as in New York city. Allowing that some discrepancy in the returns must exist, they still prove the general prevalence of this crime in one of the most intelligent and moral communities of the United States. Whoever examines the columns of country papers, and marks the large number of nostrums which in various and cunning phrases are recommended as certain to effect abortion, can not doubt the wide and almost universal prevalence of this crime. It is painful to believe that the public conscience is not alive to the moral turpitude of abortion. And yet we have frequent evidence that it not only is not shocked at the criminality of the act, but that it even regards with indifference the revelations of the scenes of cruelty, debasement, and utter loss of every virtuous impulse which the courts often reveal to the public gaze. The horrible tale of seduction, abandonment, suffering and death, now so frequently brought to light generally pass without a comment. On the contrary, it is to be feared that they are read by not a few with as much interest and as little profit as the idle tales of the magazines. It can not be denied