ite
effect, and if we consider the negligence and weakness of mind of such
individuals, we should do well to recommend this proceeding whenever
there is a clear indication for inducing sterility. In this way we
avoid cruel measures, which, by the way, are almost impracticable,
which take away all hope of love and happiness from these
unfortunates, throw them into the arms of prostitution or bitter
pessimism, and make them disgusted with their own existence.

=Medical Secrecy.=--Medical secrecy and its limitation is a very
delicate question, especially in sexual matters. Opinions vary in
different countries and among different individuals. In France medical
secrecy is almost made an idol; the medical man may refuse to give
evidence in a court of law and even conceal a crime. In Germanic
countries, on the contrary, especially in German Switzerland, too
little importance is attached to medical secrecy. In short, medical
secrecy is an elastic idea which is open to different interpretations.

Although certain particular cases may present great difficulties,
there is a middle course of moral conduct which will serve the purpose
of every conscientious doctor. As a general rule the doctor's duty is
to keep secret everything confided to him by his patients, except when
the patients themselves speak openly of it, or authorize their doctor
to do so. There are, however, exceptions to this rule.

First of all it assumes normal responsibility in the patient, and is
only conditional among irresponsibles. When a lunatic, for example,
relates to a doctor, under the seal of secrecy, certain things which
depend on delirious ideas and which threaten the safety of others, or
which render certain measures necessary in the patients' own interest,
the doctor's duty is to make known the state of affairs, but only to
responsible persons. It is the same as regards children. It is
needless to say that the doctor should use all possible measures in
the interest of the patient or child.

But even with responsible persons medical secrecy has its limits. The
doctor is here only bound to secrecy so far as it does not injure the
rights of other individuals, or those of society.

It is the duty of a medical man to report all cases of smallpox or
cholera, etc., even against the consent of the patient, and to isolate
the latter to avoid an epidemic, which is contradictory to medical
secrecy. In short, he must not, under the pretext of medical secrecy,