Illegal abortion as a public health problem.

BEFORE I DISCUSS illegal abortion as a disease of society, let us look at the definition of the word "disease." In the 22nd edition of the "American Illustrated Medical Dictionary," disease is defined as "any departure from the state of health, an illness or a sickness; most specifically, a definite morbid process having a characteristic train of symptoms. It may affect the whole body or any of its parts, and its etiology, pathology and prognosis may be known or unknown." As a public health person, I would add a public health concept, epidemiology, to etiology, pathology, and prognosis. This definition is applicable equally to the individual or to the group. Thus in calling illegal abortion a disease of society, I point to the very existence of illegal abortion as a departure from a state of total health of that society. It is a morbid process in the social structure, having a characteristic train of symptoms. It does indeed affect the whole body of society or any of its parts, namely, individuals. As its etiology, pathology, and epidemiology are only partially known, its prognosis, prevention, and treatment can for the most part, therefore, only be guessed at. Go back even further in the definition of "disease" to the roots of the word in the French language: The negative "des" and the word "aise," ease mean literally un-ease; and this is truly ani uneasy condition existing in our society; so uneasy that it makes us uneasy even to contemplate it. Therefore. we have in the main preferred not to contemplate it. However, in 1955 it was exhaustively contemplated by 43 men and women from the various disciplines of obstetrics, psychiatry, public health, sociology, forensic medicine, and law and demography, who were uneasy enough about this dis-ease to sit down for eight, three-hour sessions in an effort to bring it into realistic focus. The proceedings and conclusions of this conference were published in book form in 1958. Here are some of the facts established.' Fact No. 1-In 46 states legal abortion is permitted to preserve the life of the mother; three states allow. in addition, preservation of the health of the mother. Thus in the other states* such abortions as are being performed legally, that is, therapeutic abortions, are for the most part being done on the word of psychiatrists that the unwilling mother will otherwise commit suicide. This procedure has developed because medically speaking, that is, from the point of view of diseases of the various systems, cardiac, genitourinary, and so on, it is hardly ever necessary today to consider the life of a mother as threat-