The Coming R6le of the Medical 
Profession in the Scientific 
Treatment of Crime 
and Criminals, 
AUSTIN FLINT, M.D., LL.D., 
Professor of Physiology in the Bellevue Hospital Medical 
College ; Visiting Physician to Bellevue Hospital; 
Visiting Physician to the Insane Pavilion, 
Bellevue Hospital; Consulting Physician 
to the Insane Asylums of New 
York City, etc. 
HEPBINTHD PBOM THB 
Jfeto York JHrWcal Sounwl 
for October 19, 1895. Reprinted from the New York Medical Journal 
for October 19, 1895. 
THE COMING ROLE OF 
THE MEDICAL PROFESSION 
IN THE SCIENTIFIC TREATMENT OF 
CRIME AND CRIMINALS* 
AUSTIN FLINT, M. D., LL. D., 
PROFESSOR OF PHYSIOLOGY IN THE BELLEYUB HOSPITAL MEDICAL COLLEGE ; 
VISITING PHYSICIAN TO BELLEVUE HOSPITAL ; 
VISITING PHYSICIAN TO THE INSANE PAVILION, BELLEVUE HOSPITAL I 
CONSULTING PHYSICIAN TO THE INSANE ASYLUMS OF NEW YORK CITY, ETC. 
Dr. Cesare Lombroso, in his work on The Applica- 
tions of Criminal Anthropology, quotes Rondeau as saying, 
in an essay on the death penalty : 
“ Even assassins are patients, as well as all other crimi- 
nals. They should be punished because they disturb the 
regular course of social life, because they are obstacles to 
the development of the species. 
“Conceding that every crime is the natural outcome 
and a logical consequence of some disease, its penalty should 
be nothing else than a medical treatment.” 
The idea which underlies the views of Rondeau is that 
moral liberty has no existence, and that a moral evil is the 
result of physical fault. “In his system of repression all 
prisons would be transformed into hospitals; no attempt 
would be made to improve the organization of convicts. 
* The President’s annual address before the New York State Medi- 
cal Association, October 16, 1895. 
Copyright, 1895. by T). Appleton and Company. 2 
THE SCIENTIFIC TREATMENT OF 
The thief and the vagabond would be treated by making 
them taste the joys of work, and in secluding for life those 
inaccessible to all treatment.” 
Society, I venture to say, is hardly prepared to accept 
the logical consequences of these views; but it must be 
admitted that the treatment of crime and criminals, under 
existing laws and their melhods of execution, is a failure, 
and a failure so serious in its results that it is difficult to 
imagine what will occur before a revolution takes place 
and scientific criminology and penology become established 
as part of the social fabric. 
It has been stated on competent authority that crime 
in Great Britain is responsible for an annual public expend- 
iture of ten millions of pounds sterling. “ According to 
a recent report to the Ohio Board of State Charities, the 
citizens of the United States spend an annual sum of fifty- 
nine million dollars on judiciary, police, prisons and reform- 
atories.” The president of the National Prison Congress 
of the United States says : 
“Other questions which agitate the public and divide 
parties are doubtless important; but the country can live 
and prosper under free trade and protection, under bi- 
metallism or monometallism, under Democracy or Repub- 
licanism, but it can not survive a demoralized people 
with crime in the ascendant. That crime is on the in- 
crease out of proportion to the population is indicated 
in many ways, but for the country as a whole the United 
States census is the most reliable guide. Let us look at it 
by decades: 
Prisoners. 
Ratio to population. 
1850 
6,737 
19,086 
32,901 
58,609 
82,329 
1 in 3,442 
1 in 1,647 
1 in 1,171 
1 in 855 
1 in 757 ” 
I860 
18*70 
1880 
1890 CRIME AND CRIMINALS. 
In Great Britain, Germany, France, Italy and other 
civilized countries, the penal systems do not differ very ma- 
terially from ours; and we may assume that in these coun- 
tries crime is not more successfully treated. What wonder 
is it, then, that jurists who have studied this great ques- 
tion, like von Liszt, of Germany, “admit that our existing 
penal systems are powerless against crime” ! 
The chief object of a penal system is the protection of 
society. The facts that I have just cited show that the 
protection of society against crime and criminals is becom- 
ing more and more alarmingly inefficient. 
The statements and statistics just given have not been 
exhumed from obscure sources. They are taken from Mor- 
rison’s introduction to The Female Offender, by Lombroso 
and Ferrero, recently republished in New York and exten- 
sively circulated. Without considering the merits of this 
book in the form of its mutilated and imperfect translation, 
in which it seems hardly worthy of the distinguished repu- 
tation of Lombroso, the statistics alone, given in the intro- 
duction, should awaken the public to the necessity of a 
radical reform in penal methods and the danger of delay. 
Sentimentality in questions of criminology and penol- 
ogy should be put aside. It has no more place in criminal 
law and penal administration than in medicine and surgery. 
Crime is a disease of our social organization. It is true that 
it is ineradicable, but it may be restricted within much nar- 
rower limits than at present exist. Crime calls for intelli- 
gent and scientific treatment. While crime can not be- 
abolished, all criminals are ■ not hopelessly affected with 
crime. Individuals may be protected against crime as Jenner 
has protected individuals against small-pox. Crime may 
be a constitutional disease, as in the born criminal, or it 
may be due, in individual cases, to surroundings, teaching 
or example—a sort of contagion. It has been abundantly 4 
THE SCIENTIFIC TREATMENT OF 
shown that criminals may be divided into two great classes, 
the curable and the incurable; but the disease which we 
call crime has nearly as many phases and varieties as are 
presented by the nosological catalogue. Society needs the 
aid of competent men to undertake the task of separating 
the curable from the incurable, to restore the former to use- 
fulness and to protect our social organization against the 
latter. Jurists, so-called lawgivers and those who execute 
the laws have failed. In my opinion, the only hope is in 
the medical profession. This is the explanation I have to 
give of bringing the subject of crime before the Associa- 
tion. I have lately become fully sensible of the immense 
■extent and importance of the subject in its relations to the 
profession, and, more than all, of my deficiencies in study 
and experience in the questions involved; but no problem 
can come before us more worthy of thorough investigation 
and careful consideration. I venture to recommend and 
hope that in a future meeting or meetings the Association 
may make this matter the subject of formal discussion and 
attempt to devise something to meet in a measure the ex- 
isting and pressing necessity for reform. 
It is to be feared that the medical profession can have 
little direct influence in the making or repeal of laws. The 
past does not show any encouraging success in this direction. 
The protection of the community against so dangerous and 
evident an evil as the unrestricted sale of patent medicines 
of unknown composition, many containing powerful and 
deleterious drugs, has never been accomplished. The pro- 
fession has found itself powerless against the immense 
pecuniary interests involved in the sale of secret remedies, 
and has not been able even to compel the disclosure of the 
composition of these preparations, so that the public might 
know what it is buying. How little, then, can we hope to 
do in the way of enacting intelligent penal laws or of re- CRIME AND CRIMINALS. 
pealing bad laws that have been handed down from an- 
tiquity ! Our chief hope at present is to-induce judges, 
lawyers and lawmakers to study law in the light of modern 
scientific knowledge. 
The existing system of criminal law is based upon the 
ancient idea of vengeance and retaliation in the form of 
what is known as punishment. Crimes that are not crim- 
inal and offenses that do not offend are created every year 
by legislative bodies, as well as laws which restrict the 
liberty of certain clashes, giving special privileges to others. 
Police organizations, whose duty it is to preserve rights, 
order, cleanliness, health, etc., and who are “ for the en- 
forcement of the laws and the prevention of crime,” often 
induce, by fraud and deceit, men to commit so-called 
crimes so that they may be punished therefor. Does 
not this tend to increase the number of enemies of society, 
who are already so numerous and threatening ? Are the 
real offenses against the good order and happiness of the 
people so easily repressed that we can afford to create new 
and artificial crimes by statute ? 
In its application to the treatment of crime and crimi- 
nals, the idea of the word law, in the minds of jurists and 
legislators, needs revision. In its strict and scientific sense, 
the word law means something that is laid, fixed or set. 
A law is something that exists, has existed from the be- 
ginning, and the mind of man can not conceive that it will 
ever cease to exist. Man can neither make, destroy nor 
modify a law any more than he can create or annihilate an 
atom of matter. Laws,, when known, have been discovered 
by man, not created. The laws of gravitation, of the cor- 
relation and conservation of forces, of certain diseases, and 
the most terrible and inexorable of all, the law of heredity 
and atavism, have been discovered by illustrious searchers 
after truth. Man may modify the working of certain THE SCIENTIFIC THE ATM ENT OF 
natural laws, but tbe laws themselves remain fixed and 
immutable. The universe, animate and inanimate, includ- 
ing man, exists and progresses in accordance with laws, 
known and unknown. i\Jan is subject to psychical as well 
as physical laws, and no human act is without a cause, im- 
mediate or remote. In a so-called legal sense and in its 
relations to social organization, law may be termed formu- 
lated equity and applied justice; hut, in the words of 
Blackstone, “ No human laws are of any validity if con- 
trary to the law of Nature, and such of them as are valid 
derive all their force and all their authority, mediately or 
immediately, from this original.” 
Man is a gregarious animal. An outcome of the devel- 
opment of intelligence and knowledge is social organiza- 
tion. This is in accordance with a law of Nature, and it 
involves the necessity of ordinances and regulations for 
the protection and preservation of communities. When 
these ordinances and regulations are inequitable and un- 
just, there is immediate dissatisfaction and rebellion sooner 
or later. When the natural laws of what may be called 
man’s physical organization have been violated, either in 
the individual or in his ancestry, the result is disease. A 
man mayr suffer for the faults of his own organism or from 
infection or from Contagion. It is the province of the 
physician to endeavor to cure the disease of an individual 
or care for him during its progress, so that he may be re- 
stored to health, and to protect individuals and communi- 
ties against infection and contagion, thus preventing dis- 
ease. Physicians have learned how to cure certain diseases ; 
by the applications of sanitary science and quarantine they 
protect communities against certain diseases; recent dis- 
coveries have enabled them to secure immunity from cer- 
tain diseases. In the future, carrying out recent researches 
in psychological medicine, physicians will be largely in- CRIME AND CRIMINALS. 
7 
strumental in the treatment of moral disease. It is to the 
physician that society will look for the differential diag- 
nosis between the curable and the incurable criminal. 
Scientific progress will lead us finally to abandon the an- 
cient idea of punishment of crime, and to substitute for 
it, treatment and correction. The only punishments will he 
those necessary for the enforcement of discipline in pris- 
ons and elsewhere. The treatment of criminals will re- 
solve itself into measures to reform the curable and to pro- 
tect society against the incurable. 
A necessary preliminary to the intelligent treatment of 
any disease is diagnosis; and this, which is one of the 
fundamental principles of the science of medicine, is logi- 
cally applicable to moral as well as to physical or mental 
disease. It is universally recognized that the insane are 
not responsible for their acts to the extent of deserving 
punishment. The organization of society demands that 
there be protection against the harmful acts of the insane, 
and the dictates of humanity call for the protection of 
the insane against himself. It may fairly be assumed 
that no mental disturbance taking the form of insanity 
is without a physical cause, however obscure this cause 
may be. Is it possible that every moral delinquency 
has a physical cause? It is certain that nearly every 
confirmed and incurable criminal has a special leaning 
toward a certain class of crimes. Is there a physical vice 
or defect which leads to the commission of these crimes, 
when conditions are favorable to the full development of 
this vice and to its expression in criminal acts ? These are 
questions that are occupying the minds of criminologists 
of the present day. 
It is often said that the border line between insanity 
and crime is very narrow and indefinite. The plea of in- 
sanity, which is so often presented in extenuation of cer- 8 
THE SCIENTIFIC TREATMENT OF 
tain crimes, the irresistible impulse which some insane 
persons have to commit certain crimes—such as homicide, 
suicide, stealing, arson, etc.—would seem to show that in- 
sanity, in some of its phases, readily fades into criminality, 
or that criminality may be the first manifestation of insan- 
ity. Nothing illustrates this idea more strongly than the 
distinctions that have been drawn between criminality and 
so-called moral insanity. 
To my mind, it should not often be difficult to distin- 
guish between criminality and insanity, provided the data 
from which to draw a conclusion be full and sufficient. 
There are the criminal insane and the insane criminal; 
the one, an insane person who commits crime under an 
insane impulse; the other, simply a criminal who has 
become insane. It might be difficult to fix the responsi- 
bility of the insane criminal if it were impossible to deter- 
mine the time when he became insane; but there should 
be little difficulty in making a diagnosis of the criminal 
insane. Other difficulties may also present themselves: 
An outburst of insanity, -made evident by a palpably in- 
sane act, under the influence of what seems to be a sudden 
impulse or a recent delusion, has probably been preceded 
by a delusion or delusions carefully concealed. A crimi- 
nal act, without insanity, may be discovered, the criminal 
having, during a long period of years, sedulously main- 
tained the appearance of scrupulous honesty, often assum- 
ing the cloak of religion. In some cases of this kind, it 
has been maintained that the person is morally insane and 
is irresponsible. It has always been found very difficult to 
show that a person who commits a crime against property, 
with intelligent efforts at concealment, hoping and endeav- 
oring to reap.the advantages of his crime or attempting to 
escape its consequences by flight, is irresponsible on any 
theory. A kleptomaniac steals simply because there is an CRIME AND CRIMINALS. 
impulse to steal winch he can not resist. lie does not 
profit by the crime and has no logical reason for stealing. 
The criminal, however, always expects and attempts to en- 
joy a personal advantage as the result of his crime, or he 
has a reason which to his criminal mind is logical. The 
existence of strong temptation, great need or heavy finan- 
cial burdens, sudden passion which has a logical cause, 
revenge or hatred engendered by actual injuries or wrongs, 
afford satisfactory explanations of many crimes and enable 
us to determine the question of responsibility. I can 
hardly bring myself to a belief in the existence of what is 
called moral insanity, excepting the moral defects which 
are so often observed in dementia and senility, when cer- 
tain passions remain and the normal power of seif control 
is impaired. 
To Garofalo is due the credit of indicating differences 
between the criminal and the insane, which are clearly ap- 
preciable wdth very few exceptions. In the insane, the 
accomplishment itself of the criminal act is the end and 
object, and is, in itself, a source of pleasure and satisfac- 
tion. In the criminal, the act is done as a means of ob- 
taining a material advantage, and the act itself may be re- 
pugnant. ft is the abnormal nature of the pleasure and 
the fact that no other satisfaction is sought for, which 
characterize the insane and distinguish him from the 
criminal. 
The classification of criminals is not difficult. Dr. D. 
Hack Tuke adopts the classification of Feni, with slight 
modifications: 
The criminal by passion, as a rule, has no criminal 
characteristics. lie is simply lacking in self-control and 
almost invariably experiences remorse. Actually, a criminal 
from passion is not a criminal and is not a permanent 
enemy of society. It is necessary, however, to our social 10 
THE SCIENTIFIC TREATMENT OF 
system that he should take the consequences of his crimi- 
nal acts. He does not commit crimes against property. 
The occasional criminal, or the criminal by occasion— 
the serai-criminal of Lombroso—may properly be regarded 
as belonging to the criminal class. lie may or may not 
have an opportunity or undergo temptation to commit 
crime ; but under temptation and with opportunity he may 
commit crime from mere weakness of character. Still, 
there is no occasional criminal who is without criminal 
tendencies in a greater or less degree. , 
Havelock Ellis’s distinction between the professional 
criminal and the instinctive, or the born criminal of Lom- 
broso, seems to me to be artificial. The born criminal 
almost always presents physical signs of degeneration, and 
his history often reveals heredity or atavism, his moral 
criminal characteristics usually being intensified by sur- 
roundings. It is thought by some alienists and criminolo- 
gists that there is often little difference between the horn 
criminal and the victim of so-called moral insanity ; but it 
must be admitted that a horn criminal is seldom regarded 
as insane unless he belongs to the higher classes of so- 
ciety. 
The professional criminal may he a horn criminal, with 
physical characteristics, or he may present no physical ab- 
normalities. The high-class professional is always a man 
of considerable intellectual ability, usually free from small 
vices and a hard worker. It is pretty generally admitted 
that a professional criminal past the age of thirty can not 
he rescued from criminal life. The professional criminal 
is, of course, an habitual criminal; but other habitual 
criminals there are of less ability, whose methods of exer- 
cising their vocation do not entitle them to rank with pro- 
fessionals. 
We have little or nothing to do, in a scientific way, CRIME AND CRIMINALS. 
11 
with the criminal hy passion. Sad experience and remorse 
may teach him a lesson and lead him to exercise self-con- 
trol. He must accept the consequences of his criminal 
acts; hut it is our duty, especially toward the young, to 
provide that he be contaminated as little as possible by 
surroundings while under control. So it should be with 
those who offend simply against good order or who are 
guilty of what may be termed artificial crimes. It is not a 
crime to bake or sell bread at prohibited hours or to vio- 
late certain ordinances necessary to public decorum or 
cleanliness. Many men and more women can never be 
made to feel that it is a crime to evade duties on purchases 
for their own use, yet the laws in this regard must be en- 
forced. So long as legislators continue to enact new so- 
called criminal laws every year, and officials are compelled 
to select certain of them to enforce—as it is physically im- 
possible to enforce them all—criminal statistics will never 
represent the actual detected criminality. Criminality can 
be studied in a statistical way only from the reports of 
courts and prisons; and it would contribute much to the 
accuracy of our knowledge if we could eliminate all except 
offenses against natural laws and those which are essential 
to the integrity of our social system. 
In the scientific study of crime, the physician has to do 
mainly with the occasional criminal, the habitual criminal, 
and the born criminal ; and in this study, the first thing is 
to separate these from the offender who is not a criminal 
and the occasional criminal. lie will be forced to rely 
upon the courts for facts in regard to criminal acts. Such 
and such persons, with such and such an official record, 
have committed certain offenses ; and these persons, on con- 
viction, are turned over to experts for diagnosis and treat- 
ment. The ascertainable physical and moral characteristics 
of the offender may not be useful in the determination of 12 
THE SCIENTIFIC TREATMENT OF 
the crime, but they may be very useful in the classification 
and treatment of the criminal. 
The horn criminal is seldom without physical evidences 
of what is now called degeneration. He presents certain 
physical abnormalities. In fact, according to the notions 
of Lombroso and his followers, without such abnormalities 
he is not a born criminal. All of the purely physical char- 
acteristics observed in the born criminal are present to 
some extent in the normal man. Some of those which 
have been described by Lombroso and others are: peculiar 
skull and facial conformations; left-handedness and ambi- 
dexterity ; absence or exaggeration of tendon reflexes; 
abundant hair on the head, with scanty beard ; muscular 
abnormalities; amesthesia and analgesia; unusually rapid 
recovery from wounds, or “ disvulnerability ” ; obtuse tac- 
tile sensibility ; unusual acuteness of vision ; defects in the 
sense of hearing, taste or smell; with many others less 
marked and regarded as of less importance. Take, how- 
ever, individual instances in which even a considerable 
number of these abnormalities exist. We may have a per- 
son with a marked peculiarity in skull formation, a heavy 
jaw, abundant red hair, scanty beard, diminished knee- 
jerk, defective sense of contact, acute vision, dull hearing, 
taste and smell, some muscular abnormality, and yet this 
person may pass through life, honest and upright, showing 
no criminal tendency even when exposed to temptation and 
favored by opportunity ; but it would be idle to say that, 
in a person who had committed a crime, physical abnor- 
malities found to be more frequent in the criminal than in 
the normal man, and particularly frequent in a certain class 
of criminals, may not be of great value in classifying the 
criminal, forming an estimate of his dangerous qualities 
and of the probability of reformation. A person may have 
the so-called insane ear or strikingly abnormal palate, great CRIME AND CRIMINALS. 
13 
irregularities in the development of the teeth and an insane 
ancestry, and yet we must wait for positive evidence of in- 
sanity by word, deed, or action before he can be pro- 
nounced insane. So physical abnormalities, even with 
criminal ancestry, are nevei in themselves absolute evidence 
of criminality. 
The weakness in the position that there are any positive 
physical tests for criminality is twofold. There is no fixed 
normal standard of comparison ; and the exceptions in which 
physical peculiarities assumed to be characteristic of crimi- 
nality exist in normal individuals are very frequent. 
On the other hand, the mental and moral characteristics 
of criminality are fairly positive and definite. Given a 
number of persons who have committed actual crimes; 
meaning by this certain offenses against the person or 
against property which are violations of natural laws: 
These include homicides ; all kinds of crime against prop- 
erty, with or without violence; felonious assaults; mali- 
cious injury to person or property; the aiding and abet- 
ting of crime for gain, and other forms of crime which 
readily suggest themselves. There may be excluded: of- 
fenses against good order or discipline, not in themselves 
criminal; purely social offenses; purely political offenses; 
honest differences from prevalent opinion on political, so- 
cial or religious questions; offenses against laws which 
restrict the natural rights of man ; offenses innocently com- 
mitted through ignorance, etc. The mental and moral 
peculiarities or abnormalities of these individuals may well 
be made use of in diagnosis, classification and treatment. 
Taken in connection with these, the purely physical ab- 
normalities become of great importance, as they do in the 
diagnosis, treatment and prognosis of insanity. 
As I have already said, the criminal by passion alone is 
a normal man, but deficient in self-control under provoca- 14 
THE SCIENTIFIC TREATMENT OF 
tion or strong emotion. He presents no criminal history. 
The criminal act is followed by the deepest regret and in- 
tense remorse, usually with a desire for all possible repara- 
tion. 
The criminal by occasion, or the one who commits a 
crime when occasion presents Itself in the form of tempta- 
tion and opportunity, may lack physical and moral charac- 
teristics of criminality and have no criminal heredity, being 
simply of a weak and pliable organization. This unfortu- 
nate should.be treated most carefully, and be protected, as 
far as possible, from influences which may render him an 
habitual criminal. 
The professional and the habitual criminal are the most 
dangerous enemies to society. Criminals belonging to this 
class form a criminal organization ruled by the dominating 
personality of those of superior intelligence. They may 
possess few, if any, abnormalities called degenerative ; but 
they have no feelings of remorse, even for the gravest 
crimes, are social in their habits, not solitary, and use the 
argot, or conventional language of criminals and vagabonds, 
which is never employed by the criminal by passion or the 
criminal by occasion. The professional is usually not 
cowardly like the born criminal. He is temperate, pru- 
dent, without real friendships, and his sexual ties are sel- 
dom more than transient and unstable. These aristocrats 
of the criminal world have talents and industry which, 
directed in legitimate channels, would command respect. 
With the professional criminal, crime is profitable. Dug 
dale, the author of that remarkable study of crime called 
The Juices, says: “We must dispossess ourselves of the 
idea that crime does not pay.” Again, he says : “ Those 
who do minor crimes commit about one hundred to one 
hundred and fifty offenses to one commitment, while those 
who ‘go for big money ’ get caught once out of five times.” CRIME AND CRIMINALS. 
15 
A great problem is to make crime unprofitable ; but this 
appears to be excessively difficult. The idea of Garofalo 
is certainly in the right direction. On conviction of a 
crime against property, strip the criminal of everything 
necessary to complete restitution ; or if no property can be 
reached, let the hard labor of the convict contribute as far 
as possible toward that end. As it is, the innocent sufferer 
finds it more to his advantage to compound a felony than 
to aid what is called justice; and often he is deprived of 
his liberty in a house of detention while the criminal is at 
large on bail. 
It is with the born criminal that the medical profession 
will have most to do; and the scientific study of this ab- 
normity can not fail to be of immense benefit to our social 
system. The born criminal always presents certain dis- 
tinctive mental and moral abnormalities. 
Grouping together the professional, the habitual and 
the born criminal, the same differences in intelligence and 
education are found as in the honest walks of life. Those 
who are of a low degree of intelligence are forced to limit 
themselves to crimes that are within the scope of their 
mental capacity. They replace intelligence with a low 
duplicity and cunning, and they often act under the direc- 
tion of others. These most frequently present physical 
evidences of degeneration. Experience in reformatories 
shows that many are incapable of education or even of 
learning a trade which requires a moderate degree of skill. 
A great proportion of these are incorrigible. While all 
authorities agree that education in itself is no bar to 
criminality, it must be admitted that the discipline which 
is involved in education and the avenues which it opens to 
honest remunerative labor are favorable elements in ref- 
ormation when other conditions render this possible. 
The chief defect in education observed in criminals is 16 
THE SCIENTIFIC TREATMENT OF 
in the line of technical skill. According to the observa- 
tions of Dugdale, 794 per cent, of the criminals examined 
had never learned a trade. This observation is confirmed 
by all students of criminology. 
What Havelock Ellis calls moral insensibility is always 
observed in the born criminal. It is very important to 
distinguish this from so-called moral insanity. General 
moral insensibility is a want of appreciation of right and 
wrong from the criminal’s point of view—it may be called 
perversity or depravity—and criminal acts are not followed 
by repentance or remorse. Those who are regarded as 
morally insane have no genuine remorse, and the argument 
in favor of moral insanity without responsibility is based 
on the notion that the moral insensibility is confined to a 
single class of crimes, such as forgery, breach of trust, etc. 
It is difficult to imagine that a person has a moral defect as 
regards the crime of forgery, for example, and is entirely 
honest in other regards. If the idea of monomania is to 
be discarded by alienists, the idea of moral insanity must 
also fall. As to the question of monomania, how is it pos- 
sible that a lunatic shall have a single delusion which his 
intelligence is incapable of correcting, and yet this intelli- 
gence be absolutely normal in all other regards ? The 
mental disease may manifest itself in a single delusion 
which can not be concealed ; hut none the less is it positive 
proof of mental disease. 
The born criminal never has remorse. This is, indeed, 
pathognomonic of congenital criminality. Bruce Thomson 
studied this question in four hundred criminals convicted 
of premeditated homicide, only three of whom expressed 
remorse. If it is ascertained positively, after a sufficient 
period of observation and treatment, that a criminal has no 
real remorse or repentance, it is certain that we have to do 
with an incurable born criminal. GRIME AND CRIMINALS. 
17 
The general character and inode of life of habitual 
criminals are interesting and instructive. Such criminals 
are invariably vain, superstitious, constitutionally lazy and 
improvident, and are often sentimental and excitable. They 
are social with their own kind, prone to orgies and to asso- 
ciation with a certain class of prostitutes who have the same 
kind of moral insensibility. They use among themselves 
the argot, or conventional criminal language, which is quite 
different from the ordinary vulgar slang. They are fond of 
tattooing. Lombroso says: “Among male criminals the 
practice of tattooing is so common as to become a special 
characteristic.” The high-class professional is certainly an 
habitual criminal and raaj7 be a born criminal ; but his 
habits are usually such as do not interfere with the success- 
ful exercise of his profession. 
It is impossible in the space at my command to do 
more than refer to the great questions of atavism, he- 
redity and environment in their relations to criminality. 
The Juices, that remarkable study by Dugdale, gives an 
idea of the terrible influence of heredity. The estimates 
by Dugdale from the facts which he ascertained are cer- 
tainly reasonable. lie calculated that the descendants of 
one individual, making a family of twelve hundred strong, 
entailed upon the community during a period of seventy-live 
years an amount of loss and expense equal to 11,250,000. 
If any relief is to be expected from the scourge of the pos- 
terity of criminals, it is certainly to the medical profession 
that society must look. 
When the diagnosis of the criminal and his classifica- 
tion is not to be obtained from the criminal’s own record, 
this can be made only in prisons and reformatories. A 
criminal under thirty years of age on his first conviction is 
certainly a most interesting subject for study. The result 
of such study should class him either as a criminal by pas- THE SCIENTIFIC TREATMENT OF 
sion, a criminal by occasion, a born criminal or a criminal 
insane. Tbe only way to atford an opportanity for diag- 
nosis and proper treatment is by the indeterminate sentence. 
Tbe trial by jndge and jury merely fixes tbe crime and its 
responsibility ; it can not bring to light tbe true character 
of the criminal and indications for his intelligent treatment. 
Measuring the punishment to the crime is in the spirit of 
vengeance, which does not belong to man ; it breathes no 
thought of reformation or of intelligent protection of so- 
ciety. In the words of Van Hamel: The greatest enemy 
to the new tendency in the treatment of criminals is the 
doctrine of penal satisfaction, descendant of “ ancient ven- 
geance, which has the pretension to confide to man a task 
which can only be reposed in the hands of God.” “It is 
not enough,” says Wines, “that criminal jurisprudence 
should be humane ; it must aho be intelligent.” 
The law has thrown such safeguards around the crimi- 
nal that many crimes may be committed with impunity, 
and criminals frequently escape convdction when there is 
no room for doubt in regard to their guilt. There are, 
however, few unjust convictions. In the examination of 
nearly a hundred and fifty convict witnesses in the late in- 
vestigation of the Elmira Reformatory, not more than one 
or two hesitated to admit their guilt. Dugdale says: “Of 
those who are essentially not criminal, who are of sound 
mind and body, honest and industrious and of good stock, 
there are among State prison convicts from one to two per 
cent. They are usually committed for crimes against the 
person.” The conviction of an entirely innocent person of 
honest antecedents must be of extremely rare occurrence. 
On conviction of a criminal he should be turned over 
to the State for treatment. The judge should not fix the 
so-called punishment. Fortunately, laws are not wanting 
in the Slate of New York to render possible this beginning CRIME AND CRIMINALS. 
19 
of an intelligent criminal administration. All will admit 
the value and saving to society of the reformation of crimi- 
nals; and all criminologists, without exception, regard the 
indeterminate sentence as indispensable to proper reforma- 
tory measures. I copy from The Sun of August 14, 1895, 
the following, which shows that judges have the power to 
impose indeterminate sentences, with very slight restric- 
tions and few exceptions: 
“A fact not generally known even among the lawyers who 
practise in the criminal courts in this city is that the State 
prison law provides for indeterminate sentences such as are in 
operation at the Elmira Reformatory. The provision is made 
in section 74 of the Prison law, which is as follows; 
“ ‘ Whenever any male person over sixteen years of age 
shall he convicted of a felony which is punishable by impris- 
onment in a State prison for a term to be fixed within certain 
limits by the court pronouncing sentence, the court autho- 
rized to pronounce judgment upon such offender, instead of 
pronouncing upon such offender a definite sentence of im- 
prisonment in a State prison for a fixed term, may pronounce 
upon such offender an indeterminate sentence of imprison- 
ment in a State prison for a term with minimum and maxi- 
mum limits only specified, without fixing a definite term of 
sentence within such limits named in the sentence, but the- 
maximum limit so specified in the sentence shall not exceed 
the longest period for which such offender might have been 
sentenced, and the minimum limit in said sentence specified 
shall not be less than the shortest term for which such of- 
fender might have been sentenced. The maximum term spe- 
cified in such indeterminate sentence shall be limited in the 
same manner as a definite sentence in compliance with the 
provisions of section 697 of the Penal Code.’ 
“Succeeding sections appoint the Superintendent of State 
Prisons, the agent and warden, the chaplain, the physician, 
and the principal keeper of each prison a board of commis- 
sioners of paroled prisoners for each prison. They are ta 20 
THE SCIENTIFIC TREATMENT OF 
meet from time to time, and each prisoner sentenced under 
the law has a right to appear and apply for his share on parole 
or for an absolute discharge. The commission is empowered 
to grant an absolute discharge where it believes that the pris- 
oner will live an honest life. When the members of the com- 
mission feel a ‘ reasonable probability’ only, they may parole. 
Other sections provide for the retaking of prisoners who vio- 
late their parole at any time before the maximum term for 
which they might have been sentenced expires. Although 
the leading penologists of the world advocate the indetermi- 
nate sentence system,,the judges of the courts don’t seem to 
take to it. The law has been on the statute books since 1890 
and only twenty-eight prisoners have been sentenced un- 
der it.” 
If our judges could be brought to carry out this law, an 
immense advance would at once be made in the intelligent 
treatment of criminals. Every prison should include a re- 
formatory, if for nothing else, to separate those who may 
possibly be reformed from the incorrigible. 
The born criminal, when he becomes an habitual crimi- 
nal, is and always will be an enemy of society. lie can 
not be reformed, but the safety of the community demands 
that he be kept under constant surveillance when not actu- 
ally confined. Not only is he dangerous to society at large, 
but his association with the corrigible criminal is a great 
hindrance to the work of reformation. 
The penal code provides for the treatment of the 
habitual criminal, who was defined by statute in 1881, al- 
though the first sentence under the code was pronounced 
August 29, 1895. 
I am indebted to The Sun for the following citations: 
NEW YORK STATE PENAL CODE. 
690. Habitual Criminals.—Where a person is hereafter 
convicted of a felony, who has been, before that conviction, 
convicted in this State of any other crime, or where a person CRIME AND CRIMINALS. 
21 
is hereafter convicted of a misdemeanor who has been al- 
ready five times convicted in this State of a misdemeanor, he 
may be adjudged by the court, in addition to any other pun- 
ishment infiicted upon him, to be an habitual criminal.— Code 
Cr. Proc., sec. 510. People v. McCarthy, 45 How., 97. 
691. Person, etc., of Habitual Criminal.—The person of an 
habitual criminal shall be at all times subject to the super- 
vision of every judicial magistrate of the county and of the 
supervisors and overseers of the poor of the town where the 
criminal may be found, to the same extent that a minor is 
subject to the control of his parent or guardian.— Code Or. 
Proc., sec. 514. 
692. Effect of Pardon.—The governor may grant a pardon 
which shall relieve from judgment of habitual criminality as 
from any other sentence; but upon a subsequent conviction for 
felony of a person so pardoned, a judgment of habitual crim- 
inality may be again pronounced on account of the first con- 
viction, notwithstanding such pardon.—People v. Price, 53 
Hun., 188 ; 24 N. Y. State Rep., 936. 
It is thus seen that existing Jaws in the State of New 
York provide for the classification of criminals, the ref- 
ormation of the corrigible and protection against the in- 
corrigible. All that is necessary to a practical reform, 
which must come in the near future, is a judiciary suffi- 
ciently enlightened to act in accordance with the provi- 
sions for indeterminate sentence and for the surveillance 
of the habitual criminal, and a prison organization, intel- 
ligent, earnest, and capable of carrying out reforms on 
scientific principles which are now fairly well established. 
In the work of criminal administration the physician 
should occupy a prominent place. In the words of Lau- 
rent : “ The physician should be the friend and student of 
the criminal as he is of the insane ; should know how to 
distinguish the alcoholic, epileptic, insane, the vagabond, 
and morally insane. The prison may remain a prison and 
yet be transformed through the results of criminal anthro- THE SCIENTIFIC TREATMENT OF 
pology. Prisons are inextinguishable mines for material 
for investigations in this science.” The United States initi- 
ated practically prison reforms, beginning with the House 
■of Refuge (afterward removed to Randall’s Island) in 1825 
and culminating in the Elmira Reformatory in 1876 ; and 
yet “ numbers of prisons exist nowadays which fall far be 
low the commonest requirements of a good prison system ” 
(Griffiths). 
The treatment of criminals is the great social question 
■of the present day. There is no good reason why we should 
not take advantage of the studies and experience of crim- 
inologists and penologists, treating, without malice or re- 
sentment, the criminal as a patient as well as crime as a 
disease: and there is every reason why we should study 
crime in our prisons in the same spirit in which we study 
disease in our hospitals and insanity in our asylums. The 
objects to be kept in view are the cure of the curable by 
reformation, protection against the incurable, prevention in 
the way of limiting the development of criminal tendencies 
in the young, and deterring those in whom these tendencies 
have become developed. Punishment, as retribution for 
crime, has no place in this system. Punishment, except as 
it deters, is of no advantage to society. The spirit of re- 
venge which leads an individual to kill or injure one who 
has wronged him has no place in the legal protection of 
members of our social system. What leads so many good 
citizens to condone crimes against property, if they can se- 
cure any degree of restitution, is the fact that it is of no 
advantage to the injured that the criminal be punished, to 
a certain extent at his expense and inconvenience. Pun- 
ishment, however, is a necessary element of discipline, and 
nowhere is discipline more important than in reformatories 
and prisons. 
The reformatory treatment of criminals is that which CRIME AND CRIMINALS. 
appeals most strongly to us as members of a profession 
whose mission is to alleviate suffering and preserve health 
and life. We do not ask, Is it worth while to attempt to 
reform criminals? but simply, Can they be reformed? On 
this question I can speak with the advantage of some ex- 
perience. 
In 1894 I had the honor to be a member of a commis- 
sion of investigation of the New York State Reformatory 
at Elmira, This investigation continued for about six 
months, and during that time I made a careful study of 
the methods of the institution and the results obtained. 
These results are most striking and encouraging to those 
interested in prison reform. The system—which time does 
not permit me to fully describe—involves discharge on 
parole after a certain period of treatment. It is estimated 
—and the estimate seems fair—that out of 3,725 paroled 
from 1876 to September 30, 1893, 3,051 were reformed, 
or 81 9 per cent. Out of 4,797 indefinites discharged, 
“ whether by parole, expiration of maximum term, or any 
•other way, the percentage of reformations was 63-6.” 
These calculations are based to some extent on estimates. 
In 1887 and 1888 an effort was made “to verify the esti- 
mates of probable reformation as to 1,722 prisoners who 
had been paroled prior to September 30, 1887.” Inquiries 
to prisons, relatives, employers and acquaintances of the 
men were made. Definite information was received as to 
1,125 of those paroled. Of that number reliable informa- 
tion was received that 78-5 per cent, had not fallen into 
crime. This would give a percentage of 51'28 known to 
have been reformed out of a total of 1,722 paroled. After 
six months of satisfactory conduct on parole a prisoner re- 
ceives an unconditional release. 
The Elmira Reformatory receives males between the ages 
of sixteen and thirty, after their first conviction of a crime THE SCIENTIFIC TREATMENT OF 
punishable by confinement in a State prison. They can 
not be confined longer than the maximum term of impris- 
onment for the offense of which they have been convicted. 
The minimum term of confinement is not fixed. On ad- 
mission a full description is taken, including mental 
capacity, moral qualities, education, occupation, previous 
surroundings, parentage, possible hereditary tendencies, 
etc. The inmate is put first into an intermediate or proba- 
tionary grade for six months. For bad conduct he may be 
at any time reduced to the lowest grade. After good con- 
duct for six consecutive months he is advanced to the 
highest grade. It is possible for an inmate to earn his 
parole in twelve months. The average time of detention 
of those paroled, for six years prior to September 30, 1893, 
was twenty-two months. The average maximum term of 
all indefinites received during the same period was five 
years and nine months. 
The reformatory combines within itself a prison, a 
school of letters, a school of technology, a school of physi- 
cal training, a series of manufacturing departments and a 
military organization. The trade schools embrace thirty- 
four different trades, and gave instruction, in 1893—’94, to 
about eighteen hundred inmates. Although carried on 
primarily for instruction and not for profit, the manufac- 
turing departments realized $53,458.47 profit for the year 
1892-93. 
Under the Elmira system no inmate is paroled until he 
has a situation provided for him and enough money to his 
credit to support him until he receives his first month’s 
wages. He is under surveillance for six months, and may 
be returned to the reformatory at any time within this six 
months should he violate the conditions of his parole. 
The agencies which operate in bringing about these re- 
markable results are the fol’owing: CRIME AND CRIMINALS. 
1. The indeterminate sentence, which gives hope of 
release and incites to efforts at reformation on the part of 
the inmate. 
2. The strict and inflexible discipline, including mili- 
tary training. Most inmates have never been taught self- 
control and have never been subjected to discipline. 
3. Physical training, with no opportunity for commit- 
ting excesses of any kind. 
4. Removal from surroundings and associations of a 
demoralizing character. 
5. Education and technical training. Pike, the distin- 
guished author of History of Crime in England, says: 
“ There is one great preventive for crime, one great anti- 
dote to instincts inherited from the past, and that is edu- 
cation.” 
To summarize, a criminal by instinct, his criminality 
fostered and developed by surroundings, absolutely illiter- 
ate, without a trade or means of earning an honest living, 
with a feeble and vicious physique, may be discharged 
from the reformatory on parole, physically well and strong, 
with an education not beyond his station, a skilled me- 
chanic with good employment under honest surroundings. 
He has six months in which to learn self reliance and is 
then a free man. The Elmira Reformatory well deserves 
its position as the model institution of its kind. 
It is so rare that a criminal more than thirty years of 
age—except the criminal by passion and the criminal by 
occasion—is reformed, that such are excluded from the 
benefits of purely reformatory institutions. The objects in 
the treatment of these and of the incorrigible younger crimi- 
nals are the protection of society and deterrence by example 
and fear of consequences of crime. Imprisonment and pro- 
tracted surveillance of habitual criminals is an essential ele- 
ment in the protection of society against the habitual crirni- 26 
THE SCIENTIFIC TREATMENT OF 
nal; and an imprisonment which has no attractions of any 
kind. An imprisonment at hard labor, the prisoner sup- 
ported by the barest necessaries of life, with the most rigid 
discipline and persistent surveillance after release, is what is 
required, not as retribution, but for protection alone. A dan- 
gerous man, like any dangerous animal, should be prevented 
from doing harm. We confine a dangerous lunatic, largely 
for our own protection; but not under conditions intended 
to deter men from becoming insane or to deter other luna- 
tics from committing violent acts, as is evident. Although 
an habitual criminal may be one by heredity and instinct, 
he is still capable of a certain self-control and can appre- 
ciate the consequences of criminal acts. When these con- 
sequences show little chance for profit and involve seclusion 
from society, at hard labor—which is always repugnant to 
the born criminal—and with no comforts or distractions, 
they can not fail to exert a deterrent influence; but hu- 
manity demands that criminal jurisprudence and adminis- 
tration should carefully separate from the class of incorrigi- 
ble and habitual criminals the criminals by passion and by 
occasion. 
The idea of restitution and reparation enters very little 
into the existing methods of treatment of criminals. Crime 
should be rendered as little profitable as is possible; and 
in simple justice the State should force the criminal to 
make restitution and reparation to the injured to the fullest 
possible extent. Nothing will more efficiently deter from 
crime than taking away or largely diminishing the profits of 
criminal acts. This idea of restitution and reparation per- 
vades the Italian school of criminology and is well repre- 
sented by G-arofalo. Speaking of a certain class of crimes 
against property, Garofalo, quoted by Mac Donald, says; 
“ For this there is nothing better than the forced pay- 
ment of the fine and damage to the injured party. This CRIME AND CRIMINALS. 
would produce other advantages to society. An unfaithful 
cashier or fraudulent bankrupt would know that if once 
discovered he could not enjoy the smallest part of the 
money stolen, but would have to return all, every penny, 
or otherwise he would have to work for an indefinite time 
for him whom he had robbed. This is a forcible way of 
causing the sudden reappearance of the sum that might be 
thought to be in the hands of consorts. This is much more 
useful than imprisonment for a fixed time, which is no 
profit to any one, and only adds to the damage from the 
crime the expense of supporting the prisoner. If the 
money has really been spent the offender must work with- 
out respite for the repayment of the injured party. If he 
will not do it voluntarily, he will be obliged to do it by 
working for the State, where there is no bread without 
labor. If, in spite of his efforts, he is unable to gain a suf- 
ficient sura, after a certain number of years, according to 
his age or his good will, this constraint can be fixed to ten 
or fifteen years; but this term should be lengthened as 
soon as a want of assiduity is noticed. If the delinquent 
fulfills all his obligations, he is to be released, and deprived 
only of his political rights, with interdiction of any public 
function, or of exercising commerce, if it is a case of a bank- 
rupt.” 
It is evident that the subject I have chosen is too large 
to be adequately considered in a public discourse of reason- 
able length. The tieatment of those guilty of crimes sim- 
ply against the person, including homicide and murder, of 
sexual perverts, vagabonds, tramps, beggars, alcoholics, et 
id genus omne must be passed over. Alcoholism and pros- 
titution exist and will exist. What shall be done with 
alcoholics and prostitutes, are questions of great impor- 
tance and problems that the medical profession should 28 
THE SCIENTIFIC TREATMENT OF 
attempt to solve. These problems can not be considered 
here; but T can not refrain from a brief discussion of capi- 
tal punishment. 
Capital punishment eliminates the criminal and relieves 
society from the dangers that might come from his pos- 
sible posterity. The execution of criminals is a simple 
and easy method of extermination. Aside from the satis- 
faction of the idea of retribution, the advantages to society 
of extermination and the supposed deterrent effect of exe- 
cutions commended to jurists the severe punishments 
which were inflicted in the last century. Blackstone, writ- 
ing about the middle of the eighteenth century, says that 
no fewer than one hundred and sixty crimes were made 
punishable by death in England by acts of Parliament. The 
cruel and atrocious tortures and punishments in earlier 
times, mainly the offspring of fanaticism, may well excite 
our horror. The Inquisition, with nearly throe hundred 
and fifty thousand victims between 1491 and 1808, the 
burning of persons accused of witchcraft at Salem in 1691 
and 1692, are shocking examples of legalized cruelty. At 
the present day, capital punishment is practically limited to 
the crime of murder. 
It is pretty generally conceded that a man has a moral 
right to take the life of another in defense of his own ; but 
have we a moral right to take a human life, either in the 
exercise of retribution, to prevent subsequent harm at the 
hands of the criminal, or to deter, by example, others from 
taking life ? If it is criminal for an individual to take 
the life of another from motives of vengeance, it is equally 
criminal for society to take a human life as punishment for 
crime. At times of great danger it may be necessary to 
sacrifice human life to preserve discipline ; but this is a 
measure of self-defense. We certainly should be able to 
prevent a murderer from.repeating his crime without com- CRIME AND CRIMINALS. 
mitting a legalized murder. The only argument, to my 
mind, that remains in defense of capital punishment is 
that it may he deterrent. 
The arguments advanced by the advocates of capital 
punishment are certainly very strong, Garofalo says that 
murders always increase in proportion as the severity of the 
punishment for this crime is relaxed ; and. he cites statistics 
from Belgium, Italy, Great Britain, Switzerland and France 
in support of the view that the effect of capital punishment 
is deterrent. On the other hand, there are strong argu- 
ments in support of the proposition that capital punishment 
is not deterrent. That public executions are demoralizing 
and brutal, every one will admit. The moral insensibility 
of murderers is well known, as well as the bravado of those 
who pose as heroes and the emotional displays of those 
who profess repentance and “ change of heart.” Mac- 
Donald quotes a statement that, out of a hundred and sixty- 
seven persons condemned to death in England, a hundred 
and sixty-four had been present at executions. 
The argument that 1 shall present against capital pun- 
ishment, and one that I think can not be successfully con- 
troverted, is that the taking of human life as a punishment 
for crime is in itself a crime, is a relic of barbarism and un- 
worthy of our present civilization. No physician can con- 
sistently countenance the taking of human life. When we 
can not and will not mercifully do this to put an end to 
suffering in cases of incurable disease or in the case of dan- 
gerous and hopeless lunatics, much less can we approve of it 
as a punishment or to deter possible criminality in others. 
We may destroy the life of an unborn child to save the life 
of the mother; but then it is with extreme reluctance and 
repugnance for the act. Compared with acts of savage bru- 
tality, such as cannibalism, we may quote, with Mac Donald, 
the words of Montaigne, who says, “ it is more barbarous to THE SCIENTIFIC TREATMENT OF 
kill a live man than to roast and eat a dead one.” We need 
not go very far back to find acts provided for and sanctioned 
by law and so-called necessity which civilization would not 
tolerate at the present day. Before Pinel, in 1792, with his 
own hands removed the chains from lunatics at the Bicetre, 
the conditions of confinement of the insane were horrible 
beyond description. The tortures of criminals and suspects 
a few decades ago' were worthy only of savages; and many 
of the executions were brutal murders. When John How- 
ard made his inspections of penal institutions in 1773, the 
prisons were hells upon earth. As scientific progress has 
brought about the wonderful reforms in the treatment of 
the insane, so the same spirit should remove the last glar- 
ing relic of barbarism, capital punishment. It is an un- 
worthy reproach to science to assert that society has but 
one way of deterring the greatest of all crimes, and that is 
by repeating the crime itself under the cover of law. Even 
in the punishments which are necessary to the enforcement 
of discipline, the “golden rule ” laid down by Bike should 
be observed : “ Let them not afford an evil example of 
cruelty to the spectators.” 
Emancipation from fanaticism and bigotry is the first 
necessity in the intelligent treatment of crime. Fanaticism 
is responsible for the early persecution of scientific discov- 
erers, such as Galileo, the persecution of the Jews, the 
massacre of St. Bartholomew, and the numberless crimes 
committed in the name of the divine right of kings. The 
Puritans landed in America in 1020 to escape religious 
persecution and to enjoy religious liberty ; and they hanged 
witches in 1692. No great progress can be made in the 
reform of criminal jurisprudence until the laws based on 
bigotry and intolerance of personal and religious liberty 
are removed from the statute books. 
It is to the physician and the scientific student of CRIME AND CRIMINALS. 
crime that we must look for real reforms. The history of 
criminality is full of solemn warnings of dangers incident 
to existing systems in the treatment of crime, and the 
greatest of these is heredity. The history of The Juices 
conveys this warning in the strongest possible manner. 
We are justified by public opinion in protecting ourselves 
from the dangerous insane by perpetual confinement. The 
dangers we have to provide against from the habitual 
criminal are much greater, as he is an enemy with more or 
less intelligence, acting with method and in concert with 
others. All criminologists agree that such criminals, when 
irreclaimable, should be put under perpetual confinement 
or surveillance. Dugdale says: “In dealing with the 
habitual typical criminals who are contrivers of crime, 
criminal capitalists and panders, wheie we can not accom- 
plish individual cure we must organize extinction of their 
race. They must sternly be cut off from perpetuating a 
noisome progeny either by the propagation or perversion 
of a coming generation. The old laws attempted this ex- 
tinction by hanging; but for us it must be perpetual im- 
prisonment, with certain mitigations to guard against bar- 
barity. For this class, congregate imprisonment is perhaps 
the most suitable.” 
Dugdale evidently did not care to suggest a method of 
organizing “ extinction of their race ” ; but one less severe 
than hanging readily suggests itself. It would be not diffi- 
cult to devise a method of sterilization of irreclaimable born 
criminals which would not offend sentimental public opin- 
ion ; this to be applied, not as a punishment for any par- 
ticular class or classes of crime, but merely for the protec- 
tion of society, and after a full scientific investigation of 
every case. 
In concluding my very inadequate treatment of the 
great questions considered in this discourse, I do not make 32 
THE treatment of crime and criminals. 
any formulated suggestions; but it must be evident that 
criminology and penology should receive more attention at 
the hands of the medical profession. The State of New 
York is the birthplace of practical penal reform. Let her 
do her full share now in the good work ! While it would 
be desirable to adjust our criminal laws so as to bring them 
into accord with the present scientific status of criminology, 
existing laws admit of important reforms. A scientific 
spirit might be infused into the prison commission if it 
included members of the medical profession. Physicians 
to prisons should study criminals according to modern 
methods and not simply prescribe for their bodily ailments. 
Much study and accumulation of material are necessary to 
bring criminal anthropology to a condition approaching a 
positive basis, and for this work criminologists look to the 
medical profession. As I have already said, I venture to 
hope that criminology and penology will not be neglected 
by the New York State Medical Association. The New York Medical Journal 
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