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 Naecke 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]