which used to
be tolerated, or even approved, by many in the profession are at present
absolutely and justly condemned. The learned physician these days is no
longer afraid to face the moral philosopher; there is no longer any
estrangement between Ethics and Medical Practice. Medicine, sent from
Heaven to be an angel of mercy to man, is now ever faithful to its
beneficent mission; it never more performs the task of a destroying
spirit, as--not in wantonness, but in ignorance--it did frequently
before.

On these lines, then, of the improved understanding of first principles,
I will now proceed to develop the teachings of Medical Jurisprudence.

The first principle that I will lay down for explanation is, that a man
is not to be held responsible for all his acts, but only for those which
he does of his own free will, which, therefore, it is in his power to do
or not to do. These are called _human_ acts, because they proceed from a
distinctively human power. A brute animal cannot perform such acts; it
can only do under given circumstances what its impulses prompt it to do;
or, when it experiences various impulses in different directions, it can
only follow its strongest impulse; as when a dog, rushing up to attack a
man, turns and runs away before his uplifted stick. When a bird sings,
it cannot help singing; but a man may sing or not sing at his choice;
his singing is a human act. When, however, under the impulse of violent
pain, a person happens involuntarily to sigh or groan or even shriek,
this indeed is the act of a man, but, inasmuch as it is physically
uncontrollable, it is not a human act. So whatever a patient may do
while under the influence of chloroform is not a human act, and he is
not morally responsible for it. His conduct under the circumstances may
denote a brave or a cowardly disposition, or it may indicate habits of
self-command or the absence of them. His prayers or curses while thus
unconscious are no doubt the effects of acquired virtues or vices; yet,
in as far as his will has no share in the present acts, they are not
free or human acts. He deserves praise or blame for his former acts, by
which he acquired such habits, but not for his unconscious acts as such.

From this principle it follows that a physician is not responsible to
God or man for such evil consequences of his prescriptions or surgical
operations as are entirely beyond his will and therefore independent of
his control. If, however,