Dr. Talmey has said: "Continence, if long continued, has been claimed to be the cause of impotence. But there is no valid reason for this belief.
To prove the harmfulness of continence an a.n.a.logue is brought forward between the atrophy of a muscle in enforced idleness and the injury to the s.e.x organs in enforced abstinence. But the proof is somewhat feeble.
The essential organs of generation are not muscles, but glands, and who has ever heard of a tear gland atrophying for lack of crying. * * *
There is no valid proof of the harmfulness of total abstinence in a healthy individual. A perfectly healthy man is never injured by abstinence. At least there is no sufficient proof that he ever was; but there are unmistakable proofs that total abstinence does not harm the individual."
Dr. Stockham has said: "The testes may be considered a.n.a.logous to the salivary and lachrymal glands, in which there is no fluid secreted except at the demand of their respective functions. The thought of food makes the mouth water for a short time only, while the presence of food causes abundant yield of saliva. It is customary for physicians to a.s.sume that the spermatic secretion is a.n.a.logous to bile, which, when once formed, must be expelled. But subst.i.tute the word "tears" for bile, and you put before the mind an idea entirely different. Tears, as falling drops, are not essential to life and health. A man may be in perfect health and yet not cry once in five or even fifty years. The lachrymal fluid is ever present, but in such small quant.i.ties that it is unnoticed. Where are tears while they remain unshed? They are ever ready, waiting to spring forth when there is an adequate cause, but they do not acc.u.mulate and distress the man because they are not shed daily, weekly, or monthly. The component elements of the tears are prepared in the system, they are on hand, pa.s.sing through the circulation, ready to mix and flow whenever they are needed; but if they mix, acc.u.mulate and flow without adequate cause, there is a disease of the lachrymal glands.
While there are no exact a.n.a.logies in the body, yet the tears and the spermatic fluids are much more closely a.n.a.logous in their normal manner of secretion and use than are the bile and the s.e.m.e.n. Neither flow of tears nor of s.e.m.e.n is essential to life or health. Both are largely under the control of the imagination, the emotions, and the will; and the flow of either is liable to be arrested in a moment of sudden mental action."
Parkhurst says: "The prostatic fluid, according to Robin, is secreted at the moment of e.j.a.c.u.l.a.t.i.o.n. The remaining element of the spermatic secretion is produced, under normal circ.u.mstances, only as required, either for impregnation or for the maintenance of the affectional function. The theory that the sperm is naturally secreted only as it is required, brings it into harmony with other secretions. The tears, the saliva, and the perspiration, are always required in small quant.i.ties, and the secretion is continuous; but if required in great quant.i.ties, the secretion becomes great almost instantly. The mother"s milk is chiefly secreted just as it is required for the infant, and when not required the secretion entirely ceases; yet it recommences the moment the birth of another child makes it necessary. * * * A man accustomed to abstinence will not suffer from any acc.u.mulation of secretions, while a man whose absorbing glands have never had occasion to take up the secretions will be in trouble; just as a dairy cow which has not been milked will be in trouble, though if running wild she would never have any necessity for milking. * * * The objection that man needs physical relief from a continuous secretion is answered by the admitted fact that men not deficient in s.e.xual vigor live for months, and probably for years, in strict abstinence, and with no physical inconvenience such as is often complained of by men who happen to be deprived of their accustomed indulgence for a week or two at a time."
Dr. Nystrom, the eminent Swedish writer on the subject, however, utters the following warning to those who would make hasty generalizations on the subject: "In speaking of relative abstinence or regulation and command of the s.e.xual instinct, I warn against absolutism in this regard, and especially against the generalizing of abstinence as possible for everybody. Although abstinence during an entire lifetime does not injure certain individuals, it cannot be endured by others for some length of time without undesirable consequences. I therefore oppose the principle of absolute continence as in the main false. It may possibly be applied to a few deeply religious or philosophical persons, but not to the majority of normal people, despite good resolutions and habits. * * * We must consider the different bodily const.i.tutions and pa.s.sions--why some people without difficulty, others with the greatest difficulty, can master their feelings regarding s.e.xual relations. * * *
May those who try to better humanity in s.e.xual respects first give their attention to the subject when well prepared with a rich experience and deep study, for otherwise they cannot give advice which can be followed, and their work should fail as being contrary to human nature."
TEMPORARY CONTINENCE. Many married couples who are desirous of preventing too-frequent conception, or conception following too soon after the birth of the youngest child, practice the method of refraining from the marital s.e.xual relations during certain periods in which conception is most likely to occur. This custom is said to be favored by those acting under the advice of their religious instructors, and who regard all methods of birth-control other than continence as sinful.
Even the most orthodox objectors to birth-control as a general principle seem to regard this particular method as free from objection, providing that the married couple do not seek to entirely escape parenthood in this manner.
This plan is based upon the well-known, and well-established physiological principle that THE TIME IMMEDIATELY BEFORE THE MENSTRUAL PERIOD, AND STILL MORE, IMMEDIATELY AFTER THE PERIOD IS THE MOST FAVORABLE TO CONCEPTION. Impregnation is most likely to occur just after the menstrual period; while from about two weeks after the beginning of the period, to a few days before the beginning of the next period, is the time of comparative sterility when impregnation and conception are the least likely to occur. Consequently, the authorities hold that the period of from ten to fifteen days after the END of the menstruation is one peculiarly free from the probability of impregnation and conception.
This plan of temporary continence, continuing during the period in which conception is most probable, and terminating when that period has pa.s.sed each month, until the new period approaches, is followed by many married couples with the full approval of the conscience and their religious guides. In many cases the result fulfills the expectations, though as there is a considerable variation observed among different women there is no absolute certainty to the plan considered as a birth-control method--at the best it is but taking advantage of the law of probabilities, the chances being in favor of the result sought.
Semi-Continence.
Semi-Continence (in the sense in which the term is employed herein) consists of the abstinence from the exercise of the procreative functions, while there is a partial manifestation of the s.e.xual relation. Under various fanciful names, backed by as many curious theories, this birth-control method is practiced by very many married couples in this and other countries.
Among the earlier advocates of this general cla.s.s of birth-control methods was Noyes, the founder of the one-time famous Oneida Community, who taught the doctrine of what he called "Male Continence." The gist of his teaching was as follows: That the s.e.xual relation (in its entirety) should be exercised solely for the purpose of reproduction, all else being contrary to nature. But, he held, notwithstanding this, there was possible and proper a certain degree of such physical relation which, while not opposing Nature"s laws of reproduction, yet was sufficient to afford a complete manifestation of the "affectional desire and function." In other words, as a writer has expressed it, "that one might manifest a marked degree of s.e.xual gratification and still remain continent, while feeling none of the irksome restraints of continence."
Noyes claimed that his community followed this plan with satisfactory results, the ordinary s.e.xual relations being manifested only when reproduction was specially desired and deliberately decided upon. Noyes claimed that in this way there was no secretion of the seminal fluid, and therefore no waste of the same, and no unnatural practices such attached to the common custom of "tricking Nature" by methods of preventing impregnation and conception. Parkhurst (who, as we shall see presently, followed Noyes) objected to the Noyes plan, claiming that "it necessarily stimulates into activity the generative functions of the s.e.xual batteries, and this not only causes a wasteful use of sperm, but diverts the s.e.xual batteries from their affectional function, diminishing amative attraction."
In the year 1896, Dr. Alice B. Stockham, of Chicago, published a book called "Karezza" which has since attained an enormous sale, the leading principle of which seems to have been almost similar to that of Noyes, as above stated. The book was built around the idea previously announced by the same author in an earlier book, which she stated as follows: "By some a theory called "secular absorption" is advanced. This involves intercourse without culmination." In her book "Karezza" this author further stated: "Karezza so consummates marriage that through the power of will, and loving thoughts, the crisis is not reached, but a complete control by both husband and wife is maintained throughout the entire relation, a conscious conservation of the creative energy. * * * It is both a union on the affectional plane, and a preparation for the best possible conditions for procreation."
About 1882, Henry M. Parkhurst published a booklet called "Diana," which since that time has pa.s.sed through several editions, and has had a large number of readers. The principle advocated is radically different from that of Noyes or Dr. Stockham, above mentioned, although some of the writings of Dr. Stockham seem to favor the Parkhurst idea as much as the one advanced by herself. Parkhurst, as we may see by reference to a quotation from him in connection with the Noyes" idea, did not approve of the "male continence" as taught by the latter, although he seems to have considered it a step in the right direction.
The gist of the Parkhurst idea is expressed in the following quotations from his booklet, "Diana": "In order to secure proper and durable relations between the s.e.xes, it is necessary to live in harmony with the law of Alphism, that is ABSTINENCE EXCEPT FOR PROCREATION. But if that principle is adopted alone, no means being taken to provide for the due exercise of the s.e.xual faculties, it will likely be abandoned or lead to a life of asceticism. In order to make Alphism practicable for ordinary men and women, another law has to be observed, that is, the law of s.e.xUAL SATISFACTION FROM s.e.xUAL CONTACT; understanding by the term "contact" not merely physical external contact, but using the term in its more general sense to include s.e.xual companionship, or even correspondence, bringing the minds into mental contact. The observance of this law will lead to complete and enduring satisfaction in abstinence.
"It is an observed fact that contact incites to activity the affectional action, * * * extending over the whole frame, and by their activities satisfies them, without calling into action the special generative function of the generative organs. And it is also an observed fact that the repression of this affectional activity naturally creates a desire for the exercise of the other; so that a true remedy for s.e.xual intemperance is the full satisfaction of the affectional mode of activity by frequent and free s.e.xual contact. s.e.xual satisfaction may be obtained by personal presence, conversation, a clasp of the hands, kissing, caressing, embracing, personal contact with or without the intervention of dress.
"The exercise of the affectional function tends to satiety and exhaustion in the same way as all other physical or mental exercise; but if it is not carried to excess it is a permanent benefit. * * * The principle of Alphism will tend to diminish prost.i.tution, not only by diminishing s.e.xual intemperance, even if the principle is not at once accepted in practice to the full extent, thus diminishing the temptation of the present generation, and the hereditary temptation of future generations; but also by correcting the physiological error which has led astray so many, i. e., that total abstinence is not conducive to health, or to the highest physical pleasure, but that the ordinary physical relation is an essential feature in male existence.
"To avoid misapprehension, these two theories should be clearly defined and the distinction between them explained. The doctrine of Alphism is confined to one principle, i. e., THE LAW OF ABSTINENCE EXCEPT FOR PROCREATION. Those who believe in this doctrine may be divided into different cla.s.ses. Some believe in it as a matter of duty, to be enforced by precept and self-denial; and some believe in it as a matter of right, requiring no self-denial. In the latter is included the doctrine of "Diana," which may be defined as THE LAW OF s.e.xUAL SATISFACTION FROM s.e.xUAL CONTACT. In other words, Dianism is Alphism as the result of s.e.xual equilibration."
The general idea of Parkhurst, and those who have followed his teachings in some modified or adapted form, may be said to be based upon the following general proposition: That there is a dual function in the s.e.xual relations, which may be stated as follows: (1) the function exercised from purely physiological causes, and which expresses the desire for the relation resulting in procreation; and (2) the function exercised from emotional causes, and which expresses what may be called the "affectional desire," i. e., the desire for the embrace, caress, fondling, and general companionship with the loved one of the other s.e.x.
The first one of these phases, i. e., the reproductive function, is manifested by the lower animals as well as by man, and is elemental and primitive in character. It is often manifested by man without the accompaniment of the affectional function, and at times seems to be almost entirely divorced from the idea of high human affection. The second one of these phases, i. e., the affectional function, usually accompanied the procreative function in the human s.e.xual relation, at least in the highest forms of that relation. But also, it may be and often is manifested independently of the procreative function by men and women of refinement. In fact, it would seem to be the form of physical attraction accompanying the very highest phase of love, particularly in women.
It is this affectional function which is manifested by betrothed lovers in their beautiful period of mutual understanding, sympathy, and affection. It is that characteristic of the courting days which is so precious to the woman, but which is too often sadly missed by the wife after the honeymoon. It exists often before the fires of pa.s.sion are kindled, and it persists often after the flame of pa.s.sion has died away.
It is the expression of the purest love of youth, and of the tenderest affection of age. It is this form of s.e.xual relation, physical though it may be, that is the outgrowth of evolution in man. May it not be that in this way man has "improved upon the s.e.xual habits of the animals"; and that when man violates the natural restrictions held sacred by animal life, and indulges in excessive s.e.xual relations in and out of season, that he is really manifesting a degenerative tendency instead of taking an upward step on the evolutionary scale.
There have been many excellent authorities who have held that this affectional function, and its manifestation, is far better calculated to satisfy the s.e.xual instincts of advanced men and women than is the ordinary physical s.e.xual relation. They claim that in the higher form of this affectional relation is to be found the secret of the joy, bliss, and happiness of the betrothed lovers, which alas! too often disappear when the other form of the relation is manifested, particularly when manifested to excess in the manner customary to so many married men.
They claim that in the recognition of this fact of human life and love is to be found the secret of married happiness between wedded advanced and cultured individuals. They a.s.sert that the experience of the race, rightly considered and understood, full proves this contention.
Edward Carpenter has the following to say on this point: "It is a matter of common experience that the unrestrained outlet of the purely physical desire leaves the nature drained of its higher love-forces. * * * There are grounds for believing in the trans.m.u.tability of the various forms of the pa.s.sion, and grounds for thinking that the sacrifice of a lower phase may sometimes be the only condition on which a higher and more durable phase can be attained; and that, therefore, restraint (which is absolutely necessary at times) has its compensation. Anyone who has once realized how glorious a thing love is in its essence, and how indestructible, will hardly need to call anything that leads to it a sacrifice; and he is indeed a master of life who, accepting the grosser desires as they come to his body, and not refusing them, knows how to transform them at will into the most rare and fragrant flowers of human emotion * * * Between lovers, then, a kind of hardy temperance is to be recommended--for all reasons, but especially because it lifts their satisfaction and delight in each other out of the regions of ephemeralities (which too often turn into dull indifference and satiety) into the region of more lasting things--one step nearer at any rate to the eternal kingdom.
"How intoxicating, indeed, how penetrating--like a most precious wine--is that love which is the s.e.xual transformed by the magic of the will into the emotional and spiritual! And what a loss, on the merest ground of prudence and the economy of pleasure, is the unbridled waste along physical channels! So nothing is so much dreaded between lovers as just this--the vulgarization of love--and this is the rock upon which marriage so often splits. There is a kind of illusion about physical desire similar to that which a child suffers from when, seeing a beautiful flower, it instantly s.n.a.t.c.hes the same and destroys in a few moments the form and fragrance which attracted it. He only gets the full glory who holds back a little, and he only truly possesses who is willing if need be not to possess. * * * It must be remembered, however, that in order for a perfect intimacy between two people their physical endearment must by the nature of the case be free to each other. The physical endearment may not be the object for which they come together; but, if it is denied, its denial will bar any real sense of repose and affiance, and make their mutual a.s.sociation restless, vague, tentative and unsatisfied. I think, from various considerations, that, generally, even without the actual physical s.e.x-act, there is an interchange of vital and ethereal elements--so that it may be said that there is a kind of generation taking place within each of the persons concerned, through their mutual influence on each other, as well as that more specialized generation which consists in the propagation of the race."
Count Tolstoi said on this subject: "The difference in organization between man and woman is not only physiological but extends also into other and moral characteristics, such as go to make manhood in man, and womanhood (or femininity) in woman. The attraction between the s.e.xes is based not merely upon the yearning for physical union, but likewise upon that reciprocal attraction exerted by the contrasting qualities of the s.e.xes each upon the other, manhood upon womanhood, and womanhood upon manhood. The one s.e.x endeavors to complement itself with the other, and therefore the attraction between the s.e.xes demands a union of spirit precisely identical with the physical union.
"The tendency toward physical and spiritual union forms two phases of manifestation of one and the same fountain-head of desire, and they bear such intimate relations to each other that the gratification of the one inclination inevitably weakens the other. So far as the yearning for spiritual union is satisfied, to that extent the yearning for physical union is diminished or entirely destroyed; and, vice versa, the gratification of the physical desire weakens or destroys the spiritual.
And, consequently, the attraction between the s.e.xes is not only physical affinity leading to procreation, but is also the attraction of opposites for one another, capable of a.s.suming the form of the most spiritual union in thought only, or of the most animal union, causing the propagation of children, and all those varied degrees of relationship between the one and the other. The question of upon which footing the relation between the s.e.xes is to be established and maintained, is settled by deciding what method of union is regarded at any given time, or for all time, as good, proper, and therefore desirable. * * *
"The nearer the union approaches the extreme physical boundary, the more it kindles the physical pa.s.sions and desires, and the less satisfaction it gets; the nearer it approaches the opposite extreme spiritual boundary, the less new pa.s.sions are excited and the greater is the satisfaction. The nearer it is to the first, the more destructive it is to animal energy; the nearer it approaches the second, the spiritual, the more serene, the more enjoyable and forceful is the general condition. * * * Taking into consideration the varying conditions of temperament, and above all what the contracting parties regard as good, proper, and desirable, marriage for some will approach the spiritual union, and for others the physical; but the nearer the union approaches the spiritual the more complete will be the satisfaction. The substance of what has been said is this: that the relation between the s.e.xes have two functions, i. e., the reproductive, and the affectional; and that the s.e.xual energy, if only it have no conscious desire to beget children, must be always directed in the way of affection and love. The manifestation which this energy a.s.sumes depends upon custom or reason; the gradual bringing of the reason into accord with the principles herein expounded, and a gradual reorganization of customs consonant with them, results in saving men from many of their pa.s.sions, and giving them satisfaction for their higher s.e.xual instincts and desires."
Some capable writers on the subject have held that in the practice of the methods of semi-continence, such as have been referred to in the foregoing pages of this part of the book, there may lie the danger of excessive stimulation of the s.e.xual centres, without the safety-valve of the physical and nervous relief which follows as a natural sequence in the ordinary s.e.xual relations. The advocates of these methods, however, reply that such objections while valid in the case of persons who practice the same only because opportunity prevents the performance of the usual physical relation, still have no true application to those who adopt these methods in a conscientious and honest manner, and who maintain THE PROPER MENTAL ATt.i.tUDE toward the whole question.
These advocates say that the MENTAL EFFECT upon the secretions of the body must be taken into account in all considerations of the question.
They say that just as the gastric juice will begin to flow in response to the mental image or idea of food, and the mother"s milk in response to the cry of the child for food, so do the s.e.xual secretions, direction of the circulation, and other physiological activities result from the mental pictures or idea of s.e.xual congress. They hold that if the mind of the husband be filled with mental images of s.e.xual congress, then there is set into operation the process of secretion of seminal fluids, and the consequent engorgement of the blood-vessels concerned therewith, which are denied the normal physiological relief, and accordingly produce bad effects upon the nervous system. But they likewise claim that if the mind of the husband entertains ideas merely of physical endearment and caress as "an end to itself," then there is no mental incentive toward the secretion of the seminal fluids, and the constant engorgement of the blood-vessels, and no nerve force is generated--and therefore no nerve-shock is experienced by reason of frustrated manifestation and expression.
Parkhurst says regarding the point just mentioned: "In the relations between the s.e.xes, the question of how the a.s.sociation of the husband and the wife shall stimulate the affectional or generative action or s.e.xual batteries must depend greatly upon their habits of a.s.sociation.
We have only to accustom ourselves to a.s.sociating the relation with the affectional action, by repeated repet.i.tion when the affectional action is all that is felt or thought of, in order to cultivate such habits and a.s.sociations as will make the a.s.sociation tend to REPRESS pa.s.sional desires, by the direction of the s.e.xual forces into the channel of affectional attraction and functioning. * * * The form of the s.e.xual manifestation will be largely influenced, by the mind, and largely by force with these principles, and the gradual formation of habits consistent therewith, will make more and more evident their beneficial operation."
There is much interest now being taken by thinking people in some phases of the general subject of semi-continence, and many thoughtful and conscientious persons find in it at least the promise of a worthy and honest solution of the problem of Continence as applied to Birth Control. Such persons claim to find in this general cla.s.s of Birth Control methods a happy medium between the rigid practice of absolute Continence in the marriage relations, on the one hand, and the more popular methods of Contraception, on the other hand.
Contraception.
We now come to the consideration of the subject of Contraception, pure and simple, the methods of which contemplate the manifestation of the usual physical s.e.xual relations between husband and wife, accompanied by an avoidance of the union of the male and female elements of reproduction which result in conception.
It should once more be positively emphasized that BY CONTRACEPTION IS NOT MEANT ABORTION. ABORTION means "the premature expulsion of the human embryo or foetus; miscarriage." CONTRACEPTION, on the other hand, means simply the prevention of the union of the male and female elements of reproduction, and consequently, the preventing of the process which evolves the foetus or embryo. CONTRACEPTION IS PREVENTION; ABORTION IS DESTRUCTION. There is here a difference as wide as the poles. As Dr.
William J. Robinson says, in a paragraph previously quoted in this book: "In inducing abortion, one destroys something already formed--a foetus, or an embryo, a fertilized ovum, a potential human being. In prevention, however, one merely prevents chemically or mechanically the spermatozoa from coming in contact with the ovum. There is no greater sin or crime in this than there is in simple abstinence, in refraining from s.e.xual intercourse."
Unfortunately for the cause of scientific Birth Control in America, the laws of the United States (and of most of the separate States) at present prevent the public dissemination by written or printed words, or by public teaching of information concerning the contraceptive methods known to all intelligent physicians and others who have made a scientific study of the subject. The conveyal of such information, in the manner stated, is made a criminal offence, subject to heavy fines and imprisonment. Though there is a strong movement underway on the part of many intelligent and earnest citizens of this country, having for its object the repeal of such prohibitive laws, and the pa.s.sage of careful legislation designed to give the dissemination of such instruction a legal and certain status, under the restrictions imposed by common sense, intellectual honesty, and the best interests of the race--to place it upon the same footing as in certain advanced European countries--the fact remains that at the present time no person may give such information without subjecting himself to indictment and probable conviction as a law-breaker and enemy of society. UNDER THE CIRc.u.mSTANCES, OF COURSE, THERE HAS BEEN, AND WILL BE, NO ATTEMPTS TO FURNISH SUCH FORBIDDEN INFORMATION IN THIS BOOK. So long as these laws stand unrepealed on the statute books, they must be observed by all law abiding citizens.
Dr. Wm. J. Robinson, an authority on the subject, says: "We believe that under any conditions, and particularly under our present economic conditions, human beings should be able to control the number of their offspring. They should be able to decide how many children they want to have, and when they want to have them. And to accomplish this result we demand that the knowledge of controlling the number of offspring, in other and plainer words, the knowledge of preventing undesirable conception, should not be considered a criminal offence punishable by hard labor in Federal prisons, but that it should be considered knowledge useful and necessary to the welfare of the race and of the individual; and that its dissemination should be as permissible as is the dissemination of any hygienic, sanitary or eugenic knowledge."
THE ONLY POSSIBLE RELIEF FROM THE PRESENT CONDITION IS SEEN BY CAREFUL THINKERS TO BE IN THE EDUCATION OF THE PUBLIC AS TO THE NEEDS OF THE CASE, AND THE PRESENTATION OF THE SCIENTIFIC ARGUMENT IN FAVOR OF RATIONAL AND PROPER BIRTH CONTROL, TO THE END THAT PUBLIC OPINION, ONCE SEEING THE TRUTH IN THE CASE, MAY BE SUFFICIENTLY STRONG AS TO BRING ABOUT A CHANGE IN THE PRESENT ANTIQUATED AND BIGOTED LAWS. BUT, SO LONG AS THE LAWS REMAIN ON THE STATUTE BOOKS, THEY MUST BE OBSERVED AND OBEYED. EDUCATION, NOT ANARCHY, IS THE TRUE REMEDY.
The following general remarks on the subject of Contraception, by Havelock Ellis, the well-known English authority of the subject of s.e.x in Modern Society, may perhaps prove interesting to students of the general subject: Ellis says: "Many ways of preventing conception have been devised since the method which is still the commonest was first introduced, so far as our certainly imperfect knowledge extends, by a clever Jew, Onan (Genesis, Chap. x.x.xVIII) whose name has since been wrongly attached to another practice with which the Mosaic record in no way a.s.sociates him. There are now many contraceptive methods, some dependent on precautions adopted by the man, others dependent upon the woman, others again which take the form of an operation permanently preventing conception, and, therefore, not to be adopted save by couples who already have as many children as they desire, or else who ought never to have children at all and thus wisely adopt a method of sterilization. It is unnecessary here, even if it were otherwise desirable, to discuss these various methods in detail. It is even useless to do so, for we must bear in mind that no method can be absolutely approved or absolutely condemned. Each may be suitable under certain conditions and for certain couples, and it is not easy to recommend any method indiscriminately. We need to know the intimate circ.u.mstances of individual cases. For the most part, experience is the final test.
"Forel compared the use of contraceptive devices to the use of eyegla.s.ses, and it is obvious that, without expert advice, the results in either case may sometimes be mischievous or at all events ineffective. Personal advice and instruction are always desirable. In Holland nurses are medically trained in a practical knowledge of contraceptive methods, and are thus enabled to enlighten the women of the community. This is an admirable plan. Considering that the use of contraceptive measures is now almost universal, it is astonishing that there are yet so many "civilized" countries in which this method of enlightenment is not everywhere adopted. Until it is adopted, and a necessary knowledge of the most fundamental facts of s.e.xual life brought into every home, the physician must be regarded as the proper adviser.
It is true that until recently he was generally in these matters a blind leader of the blind. Nowadays it is beginning to be recognized that the physician has no more serious and responsible duty than that of giving help in the difficult path of s.e.xual life. Very frequently, indeed, even yet, he has not risen to a sense of his responsibilities in this matter.
It is well to remember, however, that a physician who is unable or unwilling to give frank and sound advice in this most important department of life, is unlikely to be reliable in any other department.
If he is not up to date here, he is probably not up to date anywhere.
"Whatever may be the method adopted, there are certain conditions which it must fulfill, even apart from its effectiveness as a contraceptive, in order to be satisfactory. Most of these conditions may be summed up in one: the most satisfactory method is that which least interferes with the normal process in the act of intercourse. Every s.e.xual act is, or should be, a miniature courtship, however long marriage may have lasted.
No outside mental tension or nervous apprehension must be allowed to intrude. Any contraceptive proceeding which hastily enters the atmosphere of love immediately before or immediately after the moment of union is unsatisfactory and may be injurious. It even risks the total loss of the contraceptive result, for at such moments the intended method may be ineffectively carried out, or neglected altogether. No method can be regarded as desirable which interferes with the sense of satisfaction and relief which should follow the supreme act of loving union. No method which produces a nervous jar in one of the parties, even though it may be satisfactory to the other, should be tolerated.
Such considerations must for some couples rule out certain methods. We cannot, however, lay down absolute rules, because methods some couples may find satisfactory prove unsatisfactory in other cases. Experience, aided by expert advice, is the only final criterion.
"When a contraceptive method is adopted under satisfactory conditions, with a due regard to the requirements of the individual couple, there is little room to fear that any injurious results will be occasioned. It is quite true that many physicians speak emphatically concerning the injurious results to husband or to wife of contraceptive devices.
Although there has been exaggeration, and prejudice has often been imported into this question, and although most of the injurious results could have been avoided had trained medical help been at hand to advise better methods, there can be no doubt that much that has been said under this head is true. Considering how widespread is the use of these methods, and how ignorantly they have often been carried out, it would be surprising indeed if it were not true. But even supposing that the nervously injurious effects which have been traced to contraceptive practices were a thousandfold greater than they have been reported to be--instead of, as we are justified in believing, considerably less than they are reported--shall we therefore condemn contraceptive methods? To do so would be to ignore all the vastly greater evils which have followed in the past from unchecked reproduction. It would be a condemnation which, if we exercised it consistently, would destroy the whole of civilization and place us back in savagery. For what device of man, ever since man had any history at all, has not proved sometimes injurious?