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_Sanitube_, manufactured by the Sanitube Co., Newport, R.I., U.S.A.

Excellent printed directions and pamphlets accompany these tubes.--E.A.R.]

It has been found that the 30 per cent. to 33 per cent. calomel ointments (and suppositories) are not suitable in all cases; and careful investigations are being made to ascertain the best germicide to use.

Whatever is used must be non-irritating, odourless, stainless, and yet strongly antiseptic. It is possible, I think, that _chinosol_[P] best fulfils the required conditions. It was first suggested by Surgeon-Commander Hamilton Boyden, R.N., of the Whale Island Gunnery School, England, who was led to choose it because of its known usefulness in ophthalmic work. It does not matter to the general public what drug is finally selected; all that matters is that it should be of proven value for the purposes required. Women can help forward this great work by deciding in their own mind: (1) That the medical prevention of venereal disease is right and wise; and (2) That the authorisation by the Public Health Departments of efficient means of preventing venereal disease will consequently have their support.

[Footnote P: _Chinosol_ (C9H6NKSO4), pota.s.sium oxyquinol in sulphonate, is a proprietary disinfectant and deodoriser. After some little experience of it in ointments and suppositories, I believe it deodorises these--an important advantage. But further investigation is necessary.--E.A.R.]

We must all of us first learn to separate the moral from the medical campaign. Both are necessary, but they must be conducted independently.

America is doing this; England is not. In England venereal disease is still officially regarded as something to be discussed; in America--as something to be destroyed. Thus America is winning and England losing the battle against the venereal microbe. The Overseas British Dominions will undoubtedly follow the lead of America--particularly that of Pennsylvania.

Hence, these newer countries may have a glorious future, England--only a splendid past.[Q]

[Footnote Q: In England the Ministry of Health refuses to authorise the sale of v.d. preventives; refuses to authorise suitable printed directions; recommends immediate and thorough cleansing but refuses to explain methods or name disinfectants; and claims that persons who sell v.d. preventives as such, with directions, are liable to police prosecution and imprisonment. (_Vide_ Circular 202, Ministry of Health, May 31st, 1921.) This may be mere "politics," but it looks uncommonly like fooling with death.--E.A.R.]

IV.--COMPULSORY TREATMENT.

All women should be in favour of reasonable measures for ensuring the voluntary, and failing that the compulsory, treatment of venereal disease among men and among women.[R] It is troublesome to prevent a man getting disease if he is running into a pool of infection, and such cesspools should be cleaned up or cleared out of the community--_i.e._, cured or quarantined. Similarly, it is even more troublesome to prevent a woman becoming infected if she is having relations.h.i.+p with an active gonorrhoeic or syphilitic man, and such men should be treated voluntarily, or compulsorily if they refuse or neglect voluntary treatment. Free treatment should be available to poor persons only; providing free treatment for all and sundry, whether they can afford to pay for it or not, is simply encouraging men and women to trust to luck rather than to disinfection. This presupposes that the teaching of self-disinfection has been done confidently and authoritatively. When prevention has been properly taught, then it is fair to penalise those who wilfully neglect to take precautions. It was a great misfortune to the Anglo-Saxons when the Contagious Diseases Acts were abolished; instead they should have been improved and extended to both s.e.xes. Their abolition was the worst blow ever struck at marriage. Fortunately, their main principles we are now beginning to re-enact in various s.e.xual Hygiene Acts. The more "drastic"--_i.e._, the more efficient--these are, the more they should be supported by those who honestly desire to _make marriage safe_.

[Footnote R: The argument that compulsory treatment would "drive the disease underground" is absurd. Venereal disease is underground now.--E.A.R.]

Apart from voluntary and compulsory treatment for venereal diseases, we certainly need voluntary and compulsory sterilisation of the unfit--diseased and feeble-minded and otherwise unfit persons, who, whatever their other qualifications may be, are unsuitable as parents. But whatever operation is decided upon, for men and for women, must in no way interfere with ordinary s.e.xual activity; otherwise it will be promptly turned down by the general public, no matter what its medical advocates may say. In marriage the partner to be sterilised is obviously the one who is unfit for parenthood.[S]

[Footnote S: Towards the end of last year, extraordinary interest was aroused throughout the United States by a decision of Judge Royal Graham, of the Children's Court of Denver. He had ordered Mrs. Clyde Ca.s.sidente to submit to an operation to make further motherhood impossible, because of the under-nourishment of her five children and the habitual insanitary condition of her home. This was the first time any American court had imposed such conditions. Judge Graham could not legally compel the mother to agree to the operation, but he told her that if she refused he would commit all her children to a home. She then agreed. Judge Graham was much influenced by the testimony of Dr. Sunderland, who described the progressive insanitary environment as more children came, and declared that in his opinion the home condition was not due to poverty but to too frequent child-bearing.

In the February, 1922, issue of _The Birth Control Review_ (New York) edited by Mrs. Margaret Sanger, the Medical Officer of a London Welfare Centre (Dr. Norman Haire, M.B., Ch.M.) definitely advocates contraception and sterilisation as a result of his experiences in a very poor part of London. Medical officers of many welfare centres now hold similar views.

In _The New Generation_, the official organ of the Malthusian League, Dr.

Barbara Crawford, M.B.E., M.B., Ch.B., strongly urges birth-control, and says:--

"I would go further and say that all those with incurable transmissible disease, all addicted to drugs or alcohol in excess, those habitually criminal or vicious, and the mentally defective, should be rendered sterile by operation, for such as these cannot or will not use control, and their children tend to inherit their parents' taint and to lead maimed and vicious lives."--Vol. I, No. 4, p. 3. _The New Generation._--E.A.R.]

V. CONCLUSION.

With the moral and social aspects of birth-control there is no need to deal further, except to say that they have recently been endorsed in England, with fine grace and high authority, by Lord Dawson of Penn (one of the King's Physicians), in an address given before the Church Congress at Birmingham, on October 12th, 1921, which has since been republished by Messrs. Nisbet at a s.h.i.+lling, under the t.i.tle of "Love--Marriage--Birth-Control." The following short extract may be quoted here:--

"Generally speaking," says Lord Dawson, "birth-control before the first child is inadvisable. On the other hand, the justifiable use of birth-control would seem to be to limit the number of children when such is desirable, and to spread out their arrival in such a way as to serve their true interests and those of their home."

As to the prevention of venereal disease, as I have said, what we must aim at is not merely the prevention of sin, but the prevention of the poisoning of the sinner; for, if not, we shall have blind babies, invalid wives, and ruined husbands: broken-hearted and broken-bodied mothers adding one fragment after another to the Nation's pile of damaged goods.

To the great-hearted public this is becoming intolerable. But they know so little, and they wait so long for what the wise ones fear to tell. Not all these fears are sordid; there is a kind and gracious reluctance to shatter ideals. It is hard at times to combine beauty and duty. The way of the truth-teller is not made easier by charges of iconoclasm. "To know all is to forgive all"; that is not paganism but Christianity. So also, "Let him that is without sin cast the first stone." "To err is human: to forgive divine." Humanity, wisdom, tolerance, are wrapped up in these sayings. Yet when we think, as think at times we must, of the romantic faith that once was ours, contrasted with the realities of present experience, s.e.x seems to have lost something of its soul of loveliness. And yet--can it ever regain this till men and women are at least _clean_?

If not--if the immoral man cannot be made better but rather worse, much worse, by needlessly infecting him with syphilis, then clearly the ideals of beauty and duty demand that we should apply effective s.e.xual sanitation to the Nation until such time as we are all, every one of us, free from venereal disease. That time is not yet--and this is the essence of the whole problem. But victory is within sight. When it comes--then, and not till then--s.e.x will regain its soul of loveliness. To this end--

"Let knowledge grow from more to more, But more of reverence in us dwell, That mind and soul, according well, May make one music as before, But vaster."

_Tennyson._

NOTE.

_The Author will reply personally to any serious question concerning the subject matter of this book, provided stamped and addressed envelope is sent to her, c/o the Publishers._

APPENDIX I.

OTHER METHODS OF CONTRACEPTION.

1. _Withdrawal._--Immediately before emission the male organ is quickly withdrawn, to avoid emission of seminal fluid in the v.a.g.i.n.a. Many men and women feel this to be unromantic and nerve-racking, and otherwise objectionable. The method is quite commonly practised, but it is unreliable in multiple connections, and where the man has not complete control over himself. It leaves the woman at the mercy of the man for protection against impregnation.

2. _Sheath or Condom_ ("French Letter").--This prevents both conception and infection (excepting in parts not covered by the sheath), but sheaths are apt to break, and sometimes a man infects himself whilst removing the sheath. Sheaths impose an impermeable medium between husband and wife, destroy contact, and may thereby prevent the joy of s.e.xual intercourse. In some cases both husband and wife become nervous wrecks, recovering their health when the sheaths are discarded; in other cases it is claimed that no harm has resulted.

3. _Antiseptic Syringing._--This is generally successful, but not entirely reliable by itself, because seminal fluid may enter the womb during connection. This method is unreliable unless applied _immediately_ after each connection, and syringing at that time is inconvenient and unromantic.

4. _Douche Can._--This is better than syringing in some ways, because the irrigation can be so arranged as to let the lotion flow into the v.a.g.i.n.a faster than it can flow out--hence distension of walls of v.a.g.i.n.a and thorough cleansing. But the arrangement of a runaway for outflowing lotion is inconvenient in most households.

5. _Quinine Pessaries, etc._--By themselves these are unreliable, no matter what the makers claim on the label. There is usually not enough quinine in them; or if there is enough, it proves irritating.

6. _Solid-Ring Check Pessary._--These are reliable only when carefully adjusted over the mouth of the womb, and many women find it very difficult to adjust this kind of pessary correctly; hence numbers of failures.

7. _Vaseline and Soap-and-Water._--Using vaseline beforehand, and urinating and using soap-and-water _immediately_ after _each_ connection, is a fairly safe way of avoiding conception and infection. But the vaseline needs to be inserted fairly high up--if possible over the mouth of the womb, and the subsequent was.h.i.+ng needs to be very thoroughly done (internally and externally). This method is commonly used by Continental women, but it is not entirely reliable by itself.

8. _Gold Spring Check Pessary._--This is an instrument, the arms of which spread out inside the womb, and the gold spring keeps the mouth of the womb open, thus facilitating infection and conception. It is claimed as a "preventive"; it is really an abortifacient, and cannot be too strongly condemned, as causing septic miscarriage (authentic records of this are available). A woman can neither insert nor remove this instrument herself.

9. _Safe Period._--It is often supposed that s.e.xual intercourse midway between the menses is unlikely to result in pregnancy. There is no such "safe period."

NOTE.--The method of "self-control" is not referred to here, because one marital relations.h.i.+p per annum might lead to an annual child. In the matter of limitation of offspring, therefore, "self-control" has no value.

APPENDIX II.

MEDICAL SUPPLIES.

_Rubber Pessaries._--Medical pract.i.tioners can obtain sets of occlusive rubber pessaries from Messrs. E. Lambert & Son, of 60, Queen's Road, Dalston, E.8. This firm has been manufacturing such articles in England since 1888, and now makes them in a wide range of sizes, and of special shape where required.

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