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+The Project Gutenberg EBook of Safe Marriage, by Ettie A. Rout
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: Safe Marriage
+       A Return to Sanity
+
+Author: Ettie A. Rout
+
+Commentator: Sir William Arbuthnot Lane
+
+Release Date: June 26, 2005 [EBook #16135]
+
+Language: English
+
+Character set encoding: ISO-8859-1
+
+*** START OF THIS PROJECT GUTENBERG EBOOK SAFE MARRIAGE ***
+
+
+
+
+Produced by Jonathan Ah Kit, Michael Ciesielski and the
+Online Distributed Proofreading Team at https://www.pgdp.net
+
+
+
+
+
+[Illustration: ETTIE A. ROUT. [_Vandyk, London._]]
+
+SAFE MARRIAGE
+A RETURN TO SANITY
+
+BY
+
+ETTIE A. ROUT
+
+
+WITH PREFACE BY
+
+SIR WILLIAM ARBUTHNOT LANE, BART., C.B., M.S.,
+(Consulting Surgeon to Guy's Hospital), etc.
+
+
+LONDON:
+WILLIAM HEINEMANN
+(Medical Books) Ltd.
+1922
+
+
+      +--------------------------------------------------------------+
+      |                                                              |
+      |               _PREVENTION OF VENEREAL DISEASE_               |
+      |                                                              |
+      |              By SIR ARCHDALL REID, K.B.E., M.B.              |
+      |                                                              |
+      |        With an Introduction by SIR BRYAN DONKIN, M.D.        |
+      |                                                              |
+      |    _Crown 8vo. 447 pages. 15s. net. Weight 2 lbs. Inland     |
+      |                        postage, 9d._                         |
+      |                                                              |
+      |  This book is addressed on the one hand to those who would   |
+      | prevent venereal disease in themselves, and on the other, to |
+      |         those who would prevent it in the community.         |
+      |                                                              |
+      |    _Lancet._--"A powerfully written and valuable volume."    |
+      |                                                              |
+      | _The Medical Press._--"We _positively assert_ that it is the |
+      |     duty of every medical man to _master_ its contents."     |
+      |                                                              |
+      |          LONDON: WM. HEINEMANN (Medical Books) Ltd.          |
+      |                                                              |
+      +--------------------------------------------------------------+
+
+
+     The French Government has bestowed the premier decoration for
+     women, The Reconnaissance Franēaise, upon Miss Ettie Rout, of the
+     New Zealand Volunteer Sisters, "for work done during the war (as
+     head of Anzac Soldiers' Club in Paris), and in 1919-1920 as head of
+     American Red Cross Depōt and Canteen at Villers-Bretonneux, where
+     she helped a great many French soldiers, and rendered precious
+     service to the civilian population of the commune." The War Office
+     also conveyed thanks to Miss Rout "for gallant and distinguished
+     services in the field." "I have it in command from the King," wrote
+     the Secretary of State for War, on 1st March, 1919, "to record His
+     Majesty's high appreciation of the services rendered."
+
+
+
+
+PREFACE.
+
+
+It affords me great pleasure to write a short preface to this book, since
+it deals with a matter in which I (in common with all those who are
+intensely interested in the health of our race) am glad to take an active
+part.
+
+To no woman has it been permitted to do the same amount of good, and to
+save more misery and suffering, both during and after the war, than to
+Miss Ettie Rout. Her superhuman energy and indomitable perseverance
+enabled her to perform, in the most efficient manner possible, a work
+which few women would care to handle, and of which but an infinitesimally
+small number are capable. The French Government fully recognised the great
+services she rendered to the Allies, and did her honour. The book she has
+written is one of very great value, in that its object is the Health,
+Happiness, Morality and Well-being of the Community.
+
+Not only has Miss Ettie Rout the qualities that characterise all great
+humanitarians, but she also possesses, in a unique degree, an intimate
+knowledge of the terrible troubles that arise from irregular intercourse,
+and of the manner in which they can be reduced and perhaps eliminated.
+
+In this book she deals with such simple hygienic measures as are little
+known in England, though they are in common use in France and in the
+United States, in both of which countries sound practical common sense
+prevails.
+
+She is persuaded that marriage is the goal to be reached by all, and that
+everything possible should be done to facilitate it, and so to diminish
+vice. In her efforts to bring about this happy issue she has the good
+wishes and congratulations of all who have the health of the community at
+heart.
+
+W. ARBUTHNOT LANE. 21, Cavendish Square, London, W.1.
+
+_March 25th, 1922._
+
+
+
+
+
+
+CONTENTS.
+
+
+                                        PAGE
+
+     FOREWORD                           xiii
+
+  I. INTRODUCTION                         17
+
+ II. PRACTICAL METHODS OF PREVENTION
+       A. FOR WOMEN                       32
+       B. FOR MEN                         51
+
+III. MEDICAL FORMULĘ                      59
+
+ IV. COMPULSORY TREATMENT                 63
+
+  V. CONCLUSION                           65
+
+     APPENDIX I                           69
+
+     APPENDIX II                          73
+
+     NOTE AND ADVERTISEMENT               75
+
+
+
+
+  "Knowledge comes, but Wisdom lingers, and I linger on the shore,
+   And the Individual withers, and the World is more and more."
+
+                                            TENNYSON.
+
+
+
+
+FOREWORD.
+
+
+This book embodies the considered opinions of twenty-five years' practical
+experience of adult life--as an official reporter and journalist, as a
+voluntary war-worker, and as a married woman. For many of the thoughts and
+expressions used I am indebted to large numbers of men and women whom I
+cannot name, and with whom I have been personally and professionally
+associated in different parts of the world. I am also indebted to the
+following medical journals for the publication, during the last five
+years, of many letters, articles, notes, etc.: _The Lancet_, _The British
+Medical Journal_, _Public Health_, _Municipal Engineering_, _Hospital_,
+_New York Medical Journal_, etc., etc.
+
+I have to thank the Society for the Prevention of Venereal Disease, the
+National Birth-Rate Commission, and the Joint Select Committee (House of
+Lords) on Criminal Law Amendment Bills for recording various statements
+and evidence.
+
+It remains only to state this fact: That on January 25th, 1922, Sir
+Arbuthnot Lane, Sir Frederick Mott, Surgeon-Commander Hamilton Boyden, of
+the Royal Navy, and Mr. Harman Freese, of Freese & Moon, manufacturing
+chemists, of 59, Bermondsey Street, London, S.E.1, met at my home to
+decide upon the best medical formulę for self-disinfecting ointment for
+men and contraceptive-disinfecting-suppositories for women. Mr. Freese
+made up sanitary tubes and sanitary suppositories in accordance with these
+formulę, but he is prohibited by law from recommending these for the
+prevention of venereal disease, and forbidden to supply printed directions
+with them, whereas similar medicaments are being retailed with printed
+directions in the State of Pennsylvania, and the Health Department
+circularises medical practitioners thus:--
+
+     "The self-treatment packet, obtainable at drug stores, to arrest
+     venereal infection after exposure, is approved by the State
+     Department of Health on the same principle as is antitoxin given to
+     diphtheria contacts. Proof is lacking that the use of this packet
+     lowers social standards. Reduction in the incidence of venereal
+     disease is a direct result."
+
+But not only in the clear, cool air of American State Departments of
+Health is the knowledge and love of sexual cleanliness fructifying. In the
+_Dublin Review_ for January-March, 1922, there is a wonderfully fine
+article on "The Church and Prostitution," by the Right Rev. Monsignor
+Provost W.F. Brown, D.D., V.G., in which he quotes from a very recent
+Moral Theology, "De Castitate," by the Rev. A. Vermeersch, S.J., Professor
+of Moral Theology at the Gregorian University, Rome, published in May,
+1921. The author of "De Castitate" gives brief answers to three questions
+put to him, which Mgr. Brown quotes in the original Latin, and of which
+the following is a translation furnished by a Catholic priest:--
+
+     "You ask
+
+     1. Whether or not it is formally sinful to use antiseptic ointment
+     before illicit intercourse.
+
+     2. Whether or not the use of such ointment may be advocated.
+
+     3. Whether or not it is lawful for chemists to sell it.
+
+     Ad. 1. Although it seems that in England (_cf. Times_, January,
+     1917) some have made a scrupulous distinction between the use of
+     this ointment _before_ and _after_, and have forbidden the former
+     while approving the latter, you need make no such distinction (of
+     course, supposing the ointment is not used by a woman to
+     sterilize). It is not wrong to seek means, indifferent in
+     themselves, which will prevent the evil consequences of sin.
+
+     Ad. 2. It would indeed be a sin to reveal such drugs or to persuade
+     their use with the intention to induce a man to commit sin; but
+     there is no harm in telling a man who is certainly going to sin how
+     to avoid the consequences. Ad. 3. If men could be restrained from
+     vice by prohibiting the sales, this should be done; but so many are
+     ready to expose themselves to danger that you cannot hope for such
+     a result from forbidding the sale. It is true this removes _fear_,
+     but the general good, and the removal of danger to the innocent
+     justifies this. Besides, it is a poor virtue which is kept from sin
+     only by the fear of disease."
+
+Having gone so far as to admit the desirability and necessity of the
+medical prevention of sexual diseases, the Roman Catholic Church will
+certainly find itself later unable to deny the desirability and necessity
+of preventing the birth of children liable to be born diseased or unfit.
+It is not practicable for a wife to take any suitable precautions against
+infection by a diseased husband, which precautions will not at the same
+time be effective, to a greater or lesser extent, in the prevention of
+conception. There is no half-way house in the matter of sexual hygiene.
+
+ETTIE A. ROUT.
+
+
+
+
+I.--INTRODUCTION.
+
+
+At present marriage is easily the most dangerous of all our social
+institutions. This is partly due to the colossal ignorance of the public
+in regard to sex, and partly due to the fact that marriage is mainly
+controlled by lawyers and priests instead of by women and doctors. The
+legal and religious aspects of marriage are not the primary ones. A
+marriage may be legal--and miserable; religious--and diseased. The law
+pays no heed to the suitability of the partners, and the Church takes no
+regard for their health. Nevertheless, the basis of marriage is obviously
+mating, or sexual intercourse. Without that there is no marriage, and with
+it come not merely health and happiness but life itself. Cut out sexual
+intercourse, and society becomes extinct in one generation. Every
+generation must, of necessity, pass through the bodies of its women; there
+is no other way of obtaining entry into the world. Hence, it is clearly
+the duty of women to understand precisely the processes involved, from
+beginning to end.
+
+With the lower animals sexual intercourse is desired only seasonally, and
+only for the purpose of reproduction. With the higher animals--man and
+women--sexual intercourse is desired more or less continuously throughout
+adult life, and desired much more for romantic than for reproductive
+considerations--that is, for the sake of health and happiness rather than
+for the sake of procreation only. A few women, and still fewer men, have
+no sexual desires. To them sexual abstinence seems more natural than
+sexual satisfaction. But for the majority of mankind and womankind--for
+all normally healthy men and women--there is this continuous desire to be
+happily mated.
+
+For the sake of health and happiness there is everything to be said for
+early marriage, but better late than never.[A] The chief obstacles to
+early and happy marriage are financial, and these would largely disappear
+if women were able to control fecundity. The chief obstacles to healthy
+marriage are the venereal diseases, and these could be extirpated in two
+or three generations if sexual cleanliness was properly taught to all
+adults, and if promiscuous intercourse was properly regulated during the
+same period. Unfortunately most women's idea of regulating promiscuous
+intercourse is to have none of it. This is impossible in the present stage
+of moral evolution, but it will become increasingly possible as we
+succeed in extirpating the venereal diseases, particularly syphilis.
+Syphilis is the one great cause of immorality, because persons born with a
+syphilitic taint (and what family is entirely free from this hereditary
+disease?) are apt to be mentally and morally deficient; hence, tend to
+indulge in anti-social and unnatural practices, such as engaging in
+promiscuous intercourse.
+
+[Footnote A: Marriage, whether early or late, cannot of course benefit and
+elevate society until the present mischievous and archaic Divorce Laws are
+simplified and reformed in accordance with modern sociology and ethics.
+Unhappy and unsuitable marriages necessarily foster immorality and promote
+disease, and the community as a whole gains by their being dissolved in a
+ready but responsible and dignified manner. The refusal of the Church to
+marry diseased persons would greatly benefit the nation, whereas its
+refusal to marry healthy divorced persons not only injures the nation but
+dishonours the Church.--E.A.R.]
+
+The normally healthy man is a highly selective creature, and the normally
+healthy woman still more fastidiously selective in romantic relationship.
+Neither man nor woman is naturally in the least attracted by promiscuous
+intercourse. On the contrary, it is repugnant to both. Both regard the
+elements of romance, reciprocity and permanence as essential. These
+elements are present in marriage and absent in prostitution. Therefore, it
+is beneath the dignity of any decent, intelligent woman to suppose that
+promiscuous relationship can ever be as happy and satisfying and
+attractive as marriage. This, apart altogether from the fact that marriage
+is fertile and prostitution infertile. No, both man and woman desire
+love-relationship, not loveless-relationship; and they are really quite
+fit to be trusted with the evolution of the race through passionate love
+and the worship of beauty, as soon as society makes harmonious provision
+for their normal sexual needs. Until society does make early marriage
+practicable for all healthy adult men and women, say between twenty and
+twenty-five years of age, extra-marital relationship, however undesirable,
+is inevitable, because there are many men to whom, at times, any woman is
+better than no woman.
+
+But extra-marital relationship is never even safe, because of its
+promiscuity and impermanence, except in properly conducted and effectively
+supervised tolerated houses. The tolerated house is absolutely necessary
+at present to protect women from disease and immorality, by confining this
+kind of intercourse as far as possible in certain definite channels. The
+abolition of the tolerated house spreads both disease and immorality into
+classes of women who would otherwise be immune, and enormously increases
+the dangers of promiscuous intercourse. Separated from their toilet
+equipment the women cannot make and keep themselves clean; on the streets
+they are not taught to refuse intercourse with diseased men; thus their
+occupation becomes more and more dangerous as medical supervision is
+removed. They inevitably become diseased; sometimes contract mixed
+infections, which they pass on to their clients--the future husbands and
+fathers of the nation--and "The sins of the fathers are visited upon the
+children even unto the third and fourth generation." All this would be
+impossible if women generally would recognise the primary fact that
+because a man is immoral that it is no reason why he should become
+syphilitic. We all want to abolish sin, but failing that we must cease
+wanting to poison the sinner. We must actively work to save him from the
+penalties of his folly, for that is the only way in which we can save his
+victims and succeed ultimately in "Making Marriage Safe."
+
+Similarly every effort should be made to prevent women becoming diseased,
+no matter how immoral they may be. The prostitute is very often a woman of
+peculiar mentality or overdeveloped animal instincts; and many women are
+driven to prostitution by drink and poverty. The prostitute class is
+largely recruited from mentally and morally deficient girls, who are
+themselves the offspring of syphilitic or alcoholic parents. Prostitution
+is the effect--not the cause--of anti-social acts and conditions. We must
+remedy the causes of these before we can hope to remove the effects. Under
+present social conditions, attempting to abolish prostitution by shutting
+up tolerated houses is just as idle as attempting to lower the temperature
+of a room by smashing the thermometer. All we can do is to make and keep
+these women clean. If we decline to do even that, then diseased women will
+succeed in contaminating our men much faster than we can instruct the men
+in sexual cleanliness.[B]
+
+[Footnote B: Diseased women will continue to cater for men so long as they
+are left free to do so, but as knowledge grows their clients will tend to
+be limited to _diseased men_. Once men clearly understand that _every_
+casual connection is a risk of disease, they will certainly tend to run
+fewer risks.--E.A.R.]
+
+And again, just as the medical prevention of venereal disease was not
+proposed, and has not been applied for the purpose of fostering or
+condoning promiscuous intercourse,[C] so the conscious control of
+fecundity by contraception must not be applied in such a way as to lessen
+the proportion of well-born citizens in the nation taken as a whole.
+Birth-control applied only by the responsible classes of the community
+combined with indiscriminate fecundity among the irresponsible masses,
+must inevitably lead to the lowering of the general average in character,
+brains and physique. It is a form of reverse selection--the responsible
+being out-bred by the irresponsible. What is wanted is the general
+application of birth-control by voluntary contraception, and the
+particular application of voluntary and compulsory sterilisation of the
+feeble-minded and unfit.
+
+[Footnote C: My own experience among the troops quite convinced me that
+the more thoroughly and carefully self-disinfection was taught, the less
+immorality there was. It was impossible to teach self-disinfection
+properly without at the same time instilling a living sense of danger into
+the minds of men and women; and this danger-sense certainly led to more
+self-restraint.--E.A.R.]
+
+Enthusiastic advocates of birth-control claim it as a means of _improving
+the race_. It is not necessarily anything of the kind. You cannot improve
+a flock of sheep or a herd of cattle by letting all the individuals breed;
+whether each individual has a small number or a large number of offspring
+makes comparatively little difference. The way to improve the flock or
+herd is to breed only from _the best_ and eliminate the unfit as breeding
+material. Changes in environment may improve or deteriorate the
+individuals of one generation, but such changes are not inheritable,
+excepting in the case of venereal disease. Syphilis, _e.g._, may damage
+the germ-cells of a man's body, and thus lead to his procreating diseased
+and damaged offspring--idiots, imbeciles, mental or moral deficients, and
+so forth, who unfortunately are fertile. Thus the prevention of venereal
+disease is a eugenic force. It is in fact the _only_ eugenic force in
+operation at present. Generally speaking, it is the well-developed and
+high-spirited and enterprising young men who travel most, and who,
+therefore, are most likely to contract and spread venereal disease. They
+come in contact with a much larger number of women than those who stay at
+home instead of wandering abroad. These well-to-do young travellers often
+marry the finest of our women, and later in life damage or sterilise them
+through latent or chronic venereal disease. Hence many one-child
+marriages--due not to the use of contraceptives, but to the action of the
+gonococcus transferred to the body of the wife.
+
+But there is this hope. It is among the mentally alert and well-informed
+men and women that birth-control is first understood and applied, and it
+is among this very same class that the medical prevention of venereal
+disease is also first understood and applied. Thus, there will tend to be
+less disease among this class than among the mentally torpid and
+ill-informed masses of the community. This in itself will not _improve_
+the race, but it will prevent the deterioration of certain classes and
+increase their numbers. Nevertheless, so long as the irresponsible and
+feeble-minded and diseased are permitted to multiply indiscriminately, as
+at present, they must ultimately outnumber and overwhelm the classes which
+are practising self-restraint or applying birth-control. This process may
+even be hastened by a political enfranchisement, which enables twelve
+feeble-minded persons to outvote two wise men six times over. Thus, to
+succeed democracy must raise and maintain the general average of brains
+and character throughout the community. In so far as it permits low-grade
+individuals to be born in the homes of the masses, and high-grade
+individuals in the homes of the classes, it is manufacturing a rod to
+thrash its own back, successful rebellion against which mode of Government
+ends in mere anarchy and chaos.[D]
+
+[Footnote D: The present need of the white race is to increase its numbers
+of fit and decrease its numbers of unfit. Over-population (except in a few
+patches of the Old World) is not likely to be a problem for the white race
+for centuries. They have several continents practically empty and
+undeveloped, and science has as yet touched only the fringe of the
+possible productivity of the earth in the matter of food supplies. The
+worst feature of the British Empire is that there are too many Englishmen
+and not enough Anzacs.--E.A.R.]
+
+One duty at any rate is quite clear. No woman should run any chance of
+conception unless she is certain of her own health and the health of her
+partner--the man who is to be the father of the child she is to bring into
+the world. If her husband's health is unsound, and she cannot avoid
+intercourse, she can certainly take precautions against conception and
+against infection. The control of fecundity and the control of infection
+are parallel problems, and generally speaking, the measures a woman takes
+to prevent conception will also prevent infection. If these precautions
+are not taken, a woman may not only become seriously ill herself, but she
+may blast the health of her unborn babe--or infect it herself during or
+after birth. Clearly then it is her personal, as well as her maternal and
+national, duty to apply preventive measures.
+
+Women should understand that there is _always_ a great deal of venereal
+disease--millions of fresh cases every year in the British Empire. During
+the war there were about half-a-million fresh infections per annum among
+the soldiers in the British armies alone--about two million men infected
+altogether at the very least.[E] Some were cured, others patched up; some
+very badly treated; some not treated at all; many demobilised while in an
+infective condition, and thus liable to come home and sow in the bodies of
+clean women the seeds of diseases picked up in foreign lands in moments of
+excitement and folly. Blame these men if we must, but in all fairness let
+us ask ourselves: _Who infected them?_ And the answer is: _Diseased
+women._
+
+[Footnote E: The devastation of these diseases among the British armies
+abroad (in the Rhine, Black Sea, and Palestine areas, etc.) has been much
+worse since the Armistice than during the war. Approximately one-fourth
+(sometimes one-half) of these armies become infected with venereal disease
+every year. From 1919 to 1921 somewhat soothing statistics were issued for
+the army of the Rhine, but these have now been admitted in Parliament to
+be "_quite unreliable_" (Parliamentary Debates, House of Commons, November
+3rd, 1921, p. 1952). It must be remembered that, owing to the exchange
+value of the £, the English soldier on the Rhine is now being paid about
+£8 or £10 per day; that is, he draws a far higher salary than the highest
+paid German official; hence there is no riotous pleasure, however
+expensive and extravagant, which he cannot afford. These conditions do not
+promote manly virtue or even sexual cleanliness.--E.A.R]
+
+The venereal diseases are passed on from one sex to the other in a
+continuous chain, but the chain can be broken at any time _by either sex_.
+And now it is the _married women_ on whom we must rely to see that these
+infections are stopped. Leaving women to the chance protection of their
+partners is demonstrably a failure. Here is an extract from a letter sent
+me recently by an old and experienced medical practitioner:--
+
+     "I have had many women under treatment _who have been continually
+     re-infected by their husbands_."
+
+Men and women must both seek knowledge and both accept responsibility for
+the venereal problem. They must face this problem independently and in
+co-operation, and above all--face it _honestly_. There is no other way.
+
+It is all very well to say that the man is responsible. That is only a
+partial truth.[F] The woman is equally responsible as soon as she is
+equally well informed. A woman's body is her own, and she will never be
+really free until she knows how to look after it properly. If she is fit
+to vote, fit to pay taxes, fit to hold her own estate under the Married
+Women's Property Act, why should she not learn to exercise intelligent and
+responsible control over her own self? Why do so many women _allow_
+themselves to be impregnated and infected against their will? Because they
+do not understand the construction and functions of their own body. When
+they do understand this, they will guard their own health as carefully as
+they guard their reputation. They will then not only keep their own sexual
+organs scrupulously clean, but they will encourage their husbands to do
+the same. Sexual intercourse is far more refreshing and exhilarating in
+every way when both husband and wife have cleansed their parts immediately
+before enjoying it. It is only natural that both should wish to be sweet
+and clean before approaching the closest of all bodily intimacies.
+
+[Footnote F: It would be much less untrue to say that the remedy for the
+venereal problem is _clean women_.--E.A.R.]
+
+But more than this. Every well-informed woman knows that there is far more
+venereal disease in the world to-day, among men and among women, than
+there was before the war, and she should train all the members of her
+household in habits of strict cleanliness. Instinctively they will then
+avoid risking their health by contact with a possible source of
+defilement, or if the risk has most unfortunately been taken, they will
+instantly and instinctively remove and destroy the possible infection, in
+the same rapid and effective way as they would cleanse their boot from
+filth accidentally coming in contact with it. By all means let the
+mothers continue to inculcate virtue, but they should also teach sexual
+cleanliness directly and indirectly, themselves setting the example. After
+all, the microbes of venereal disease grow almost exclusively in the
+genital passages, and if these were kept sweet and clean there would soon
+be an end to venereal disease. It is not a matter of making _vice_ safe:
+it is a matter of making _marriage_ safe: a matter of restoring and
+maintaining physical health, family and national, and above all, of
+protecting innocent women and children, for if vice has its dangers so
+also in these days has innocence its own peculiar perils, and it is the
+cry of these victims--often so young and so fair--that must affect us most
+deeply.
+
+More than fourteen years ago, Mr. George Bernard Shaw, in the Preface to
+"Getting Married," wrote the following regarding "The Pathology of
+Marriage":--
+
+     "As to the evils of disease and contagion, our consciences are
+     sound enough: what is wrong with us is ignorance of the facts. No
+     doubt this is a very formidable ignorance in a country where the
+     first cry of the soul is, 'Don't tell me: I don't want to know,'
+     and where frantic denials and furious suppressions indicate
+     everywhere the cowardice and want of faith which conceives life as
+     something too terrible to be faced. In this particular case, 'I
+     don't want to know' takes a righteous air, and becomes 'I don't
+     want to know anything about the diseases which are the just
+     punishment of wretches who should not be mentioned in my presence
+     or in any book that is intended for family reading.' Wicked and
+     foolish as the spirit of this attitude is, the practice of it is so
+     easy and lazy and uppish that it is very common, but its cry is
+     drowned by a louder and more sincere one. We who do not want to
+     know, also do not want to go blind, to go mad, to be disfigured, to
+     be barren, to become pestiferous, or to see such things happening
+     to our children. We learn, at last, that the majority of the
+     victims are not the people of whom we so glibly say, 'Serve them
+     right,' but quite innocent children and innocent parents, smitten
+     by a contagion which, no matter in what vice it may or may not have
+     originated, contaminates the innocent and the guilty alike, once it
+     is launched, exactly as any other contagious disease does; that
+     indeed it often hits the innocent and misses the guilty, because
+     the guilty know the danger and take elaborate precautions against
+     it, whilst the innocent, who have been either carefully kept from
+     any knowledge of their danger, or erroneously led to believe that
+     contagion is possible through misconduct only, run into danger
+     blindfold. Once knock this fact into people's minds, and their
+     self-righteous indifference and intolerance soon change into lively
+     concern for themselves and their families."
+
+The facts seem so plain, and yet there is still great opposition to the
+promotion of a knowledge of sexual cleanliness and self-disinfection. Only
+a short time ago (the end of 1920), Sir Frederick Mott, the great
+authority on syphilis, felt obliged to oppose some opponents of
+self-disinfection at a public enquiry in London in this fashion:--
+
+     "The point is that large numbers of innocent women have suffered
+     from disease. They are rendered sterile, have miscarriages and
+     abortions, and large numbers have been ruined. I have been
+     connected with the London County Asylums for twenty-five years, and
+     I have seen in those asylums people from all states of society, and
+     I have seen them die of general paralysis. Five per cent. of the
+     people who get syphilis, in spite of treatment, develop this
+     disease. That is only one aspect of it. I was on the Royal
+     Commission on Venereal Disease, and Sir William Osier, who was a
+     great authority, said that he could teach medicine on syphilis
+     alone, because every tissue in the body is affected by it, and that
+     the diseases of blindness, deafness, insanity and every form of
+     disease may be due to syphilis. You have only to consider the
+     effect that it had upon the army, and I understand that more than
+     two army corps were invalided during the war on account of venereal
+     disease. What have you to say to that? Does not that create some
+     anxiety?"
+
+It is difficult even to read this eloquent appeal--the more eloquent
+perhaps because it was quite unpremeditated--without being deeply moved.
+Yet the witnesses opposing Sir Frederick Mott were apparently unaffected.
+Of them, as of men of old, it might justly be said:--
+
+     "He hath blinded their eyes, and hardened their heart; that they
+     should not see with their eyes, nor understand with their heart,
+     and be converted."
+
+And now large numbers of hospitals all over the Empire are issuing appeals
+for the means to treat venereal disease.
+
+     "It is tragic," says one London hospital, "to see the
+     sufferers--men, women and even little children--innocent little
+     mites, knowing not from what they suffer or why they should. It is
+     thought by many that venereal disease is a sign of guilt, but large
+     numbers of our patients are innocent victims."
+
+Is it not time then that we all stopped repeating timid platitudes about
+making vice safe, and did something practical to _make marriage safe?_
+
+_Why don't we?_
+
+Is it because we are afraid to define the terms we use so glibly? We talk
+of promoting chastity, for example. _What is chastity?_ Surely chastity is
+happy, healthy sexual intercourse between a man and a woman who love one
+another; and unchastity is sexual intercourse between those who do _not_
+love one another. No sexual intercourse at all is neither chastity nor
+unchastity; it is the negation of both, and it ends in extinction. Why
+trouble so much about a negation that inevitably means racial death? Why
+not devote ourselves to life and love; to the building of a happy healthy
+human family--a family that instinctively realises that the clean
+blood-stream of a nation is its most priceless possession?
+
+But the national blood-stream can never be clean until there is a complete
+knowledge of sexual control and sanitation among all of us, and especially
+among women. One of the very first things which women must learn to
+understand is the control of conception and the control of venereal
+diseases. They must learn how to prevent the birth of the unfit; how to
+secure the birth of the fit; and even though their husbands are infective
+they must learn how to break the chain of infection in their own bodies,
+so that what is bad for the race does not become worse. If women are brave
+enough and wise enough, they can in most cases _wipe out the scourge of
+venereal diseases from their own hearths and homes_, and ensure that every
+child born is at least physically fit. But this cannot be done without
+_knowledge_, and that knowledge is at present lacking.
+
+The following pages are written with the object of imparting useful,
+practical knowledge to sensible and serious women. The women who accept
+and apply this knowledge can rest calm in the sure and certain faith that
+it is their offspring who will build up the coming race.
+
+
+
+
+II.--PRACTICAL METHODS OF PREVENTION.
+
+A. FOR WOMEN:
+
+SEXUAL REPRODUCTION.
+
+
+To understand the practical methods of birth-control, or the control of
+conception, we must first have a clear view of the processes involved when
+the reproductive organs are in activity, and of the nature and situation
+of the sexual organs themselves. The diagrams on pages 34, 35 and 36 show
+in general outline the reproductive organs of man and woman.
+
+Now fertilisation does not necessarily occur whenever the male organ comes
+in contact with the female organ. Fertilisation occurs only when a
+male-cell (spermatazoon) unites with a female-cell (ovum); in other words,
+when the spermatazoa in the seminal fluid of a man meet and unite with the
+germ or ovum in the body of a woman. That is the beginning of the child.
+This union of the two cells need not take place during or immediately
+after sexual intercourse. It may occur many hours, or even two or three
+weeks, after connection, because the spermatazoa have motion of their own.
+They are tiny threadlike bodies, which may work their way towards the
+ovum long after they have left the body of the man and been placed in the
+body of the woman, and the uterus has a searching movement, and may by its
+pulsations draw the spermatazoa upwards. For these reasons a woman cannot
+be quite sure of the exact time of fertilisation, and hence cannot predict
+exactly the date of the child-birth. Generally the pregnancy lasts nine
+months, but it may last longer--say ten months on rare occasions; and it
+may be extended apparently by a delay in fertilisation.
+
+
+PREVENTION OF CONCEPTION.
+
+For many reasons which I need not enumerate here, the precautions against
+impregnation can most easily and effectively be taken by the _woman_,
+rather than by the man. She is the one fertilised, and therefore she is
+the one to guard herself against fertilisation.
+
+There are _two methods_ of preventing fertilisation:--
+
+     (1) _The chemical method_, that is, the destruction of the male
+     cells (spermatazoa) by means of a suitable germicidal substance,
+     such as many of the disinfectants; and
+
+     (2) _The mechanical method_, that is, the adoption of measures
+     which keep the male and the female cells apart from one another.
+
+[Illustration: INNER SIDE OF THIGH.
+
+DIAGRAM 1.--Female organs of generation in normal condition. This shows
+diagrammatically the position of the organs if a woman were cut in two
+between the thighs. The rubber pessary is shown in position, slightly
+distending upper end of vagina (or front passage), and covering the
+opening into interior of womb. A suppository introduced beforehand will
+dissolve and occupy the dotted space above rubber pessary, forming a pool
+around the mouth of the womb. The walls of the vagina are elastic and
+collapsible. Infection with gonorrhoea may occur in the female urethra (or
+water passage) or in the vagina, etc. Syphilis may infect internal and
+external parts of female organs; also breasts, mouth, tongue, etc., and
+other openings of the body.]
+
+Neither of these two methods in practical application by ordinary women
+can be said to be _completely certain_. Both are apt to fail at times. The
+chemical method, that is, the application by the woman of a suitable
+soluble contraceptive suppository before connection, or of a germicidal
+douche (such as a dilute solution of lysol) after connection, or both
+these measures taken consecutively, may fail because of some fault in
+application, or because the seminal fluid actually enters the womb during
+intercourse; that is to say, when emission takes place, the end of the
+male organ may be exactly opposite and close to the mouth of the womb, and
+the spermatazoa in the seminal fluid enter directly into the womb, and
+cannot then be removed or destroyed by douching or contraceptives of any
+kind. Now if the physical conformation of the reproductive organs of the
+husband and the wife render this event possible or probable, then soluble
+suppositories and contraceptive douching are alike unreliable, by
+themselves or in combination. On the other hand, the mechanical method,
+that is, the use of a rubber protector, preferably the spiral-spring
+occlusive[G] "Dutch" pessary, by the woman may also fail, because the
+protector is porous or ill-fitting. But--_if the two methods are
+combined_, the chemical method and the mechanical method, _then the
+protection against fertilisation may be regarded as almost absolute_. The
+completeness of the protection depends, of course, upon the proper
+application and combination of the measures advised.
+
+[Footnote G: Judging by certain original letters (dated December, 1888, to
+November, 1892), which I have seen myself, by the courtesy of Messrs. E.
+Lambert & Son, of 60, Queen's Road, Dalston, London, E.8, the rubber
+spring pessary was first suggested here by an English doctor, and
+manufactured for him by Mr. E. Lambert Sen. Under date December 23rd,
+1888, the doctor wrote:--
+
+"I think highly of the watch-spring rim. There will be very little fear of
+conception with one of these new pessaries properly adjusted, as the rim
+will press equally all round. The inflated pessary would be the most
+perfect, however, if you could only contrive some method to prevent escape
+of air and consequent flattening. Such a pessary would be most
+comfortable."]
+
+[Illustration: UTERUS, OVARY AND FALLOPIAN TUBE.
+
+DIAGRAM 2.--The Fallopian tubes and ovaries are not shown on Diagram 1.
+There are two ovaries and two Fallopian tubes, one on each side of the
+uterus. The female cells or ova are formed in the ovaries and discharged
+into the Fallopian tubes, along which they travel into the uterus. It is
+believed that the union of the male with the female cell usually occurs in
+the Fallopian tubes, but that it may occur in the uterus.]
+
+[Illustration: DIAGRAM 3.--This diagram shows the male urethra or passage
+down the male organ as somewhat distended. Generally, the walls of this
+passage are collapsed together. The seminal fluid is discharged down the
+urethra and emitted at orifice marked "meatus." The small glands indicated
+are especially liable to be infected with gonorrhoea germs, but infection
+may occur almost throughout the entire length of the male passage.
+Infection with syphilis may occur on the outside of the male organs and
+elsewhere.]
+
+I have discussed the various measures fully with leading medical
+authorities in London and Paris and elsewhere during the last five years,
+and have gradually evolved the recommendations made here, and these
+recommendations have the highest medical and scientific support and
+approval. Other methods than those recommended are referred to in Appendix
+I; to enumerate here those that have been eliminated would be purposeless
+and confusing. We are satisfied that we have selected the least harmful
+and most reliable methods known to science yet. These methods and these
+only will be explained and recommended. Everything possible has been done
+to make the methods _acceptable to women_.
+
+
+UNATTAINABLE CONDITIONS.
+
+Before detailing these methods, I want to ask every woman to rid her mind
+of certain false hopes and impossible demands. It is no use asking for
+something which gives no trouble at all, which costs nothing, and which is
+at the same time absolutely certain to prevent conception. These
+conditions are unattainable. But almost absolute control of her
+reproductive functions is most certainly attainable by every careful,
+intelligent woman willing to spend a good deal less time and money over
+her sexual toilet than she now spends over the care of her teeth, for
+example.
+
+
+SEXUAL TOILET OUTFIT.
+
+To begin with, it is necessary to obtain suitable sexual toilet outfit,
+and the requirements for this are as follows:--
+
+Enamel bidet, soluble suppositories, suitable syringe, and
+properly-fitting rubber pessary. These are illustrated on pages 38 and 43.
+
+[Illustration: Diagram 4]
+
+
+GENERAL CONDITIONS.
+
+1. _Cleanliness._--Sexual control is largely a matter of sexual
+cleanliness. We must all learn to keep the genital passages cleansed in
+the same way as we keep all the other openings of the body clean. The
+ears, eyes, nostrils, mouth, anus, orifice to the urethra, and the vagina
+should be appropriately cleansed daily. The openings of the body which
+stand most in need of daily cleansing are the anus and the vagina, and yet
+many women fail to cleanse these properly at all. Every home should have a
+suitable bidet (preferably fitted into the bath-room, with hot and cold
+water attached), and every member of the family should be trained from
+childhood to use the bidet, night and morning, with the same care and
+regularity as they use their sponge or toothbrush. All over the Continent
+and in the United States of America this is done in well-ordered
+households nowadays, but hardly anywhere in the British Empire is it done
+at all.
+
+2. _Soluble Suppositories._--Generally speaking, the soluble quinine
+pessaries or suppositories which are sold in the shops are unreliable.
+Several brands have recently been analysed and found to contain no quinine
+at all--or particular pessaries have been without sufficient quinine.
+Quinine is fatal to the spermatazoa, and without it these pessaries are
+simply pieces of soluble cocoa-butter. Cocoa-butter is the substance
+generally chosen for cheap soluble pessaries, because it is easily
+obtainable, and has what is called a sharp melting point--that is, it
+dissolves or melts very suddenly and readily at body-heat, but is solid
+below that heat. Cocoa-butter in itself is quite harmless--usually
+non-irritating (unless it is "rancid")--and it gives some mechanical
+protection, in the same way as vaseline or any kind of fat or oil would
+do, provided, of course, it is in the right place to catch and entangle
+the spermatazoa and thus prevent their uniting with the ovum. Research and
+experiment have proved conclusively that no spermatazoa--indeed, _no
+microbes or germs of any kind--can pass through a film of oil_. But if the
+protective covering of grease is incomplete at any point, it may there
+prove ineffective, and there is no chemical protection whatever if the
+particular germicide relied upon, such as quinine, has been omitted.
+Quinine is sometimes omitted on the ground of expense, and sometimes
+because it proves irritating to many women. Only really suitable
+suppositories, guaranteed to be made in accordance with accredited medical
+formulę, should be used. These suppositories should be composed of
+specially selected and tested fats, should be soothing and cleansing, as
+well as protective; should be stainless, odourless, and quite
+non-irritating. If they do cause any woman discomfort temporarily,
+vaseline or soap-suds could be substituted, but might not be quite so
+certain to prevent conception.
+
+3. _Syringe._--The ordinary enema is not a particularly suitable appliance
+for the purpose of douching. The kind of syringe required is one which
+will not only flood the vaginal passage with warm water or very weak
+antiseptic lotion (such as dilute solution of lysol), but one which is
+sufficiently large for the contents on injection to distend slightly the
+walls of the vagina, straighten out their folds and furrows, and thus let
+the cleansing and protecting lotion touch every part as far as possible. A
+movable rubber flange is necessary to act as a stopper at the mouth of the
+vagina, and thus enable the woman to retain the lotion for a minute or so.
+Care should be taken, when filling the syringe, to express all the air
+from it--by filling and refilling it two or three times with the nozzle
+under water; otherwise the first thing put into the vagina would not be
+warm water or antiseptic lotion, but simply a large bubble of air.
+
+4. _Soluble Suppositories and Rubber Pessaries._--It is quite true that
+the use of a suitable soluble suppository alone may be sufficient to
+protect against impregnation, but the protection by this means does
+undoubtedly fail at times, and therefore, by itself, the soluble
+suppository is unreliable. Still it eliminates the majority of the chances
+of impregnation. The use of the rubber pessary is also sometimes
+unsuccessful because it does not fit properly, or because it is porous, or
+because in removing it some of the seminal fluid from the under-surface
+may be accidentally spilt in the vagina, and in this way the spermatazoa
+may later find their way upwards to an ovum. Therefore, the soluble
+suppository and the rubber pessary should be used in combination. A woman
+should first push up, as far as possible, a suitable suppository, and then
+insert the rubber pessary (slightly soaped--with soap-suds), so as to
+occlude the whole of the upper part of her genital passage and thus cover
+the mouth of the womb and effectively prevent entrance of the spermatazoa.
+The rubber pessary _must_ in the first instance be fitted by a doctor,
+because if it does not fit properly it will be ineffective. The seminal
+fluid may pass by its loose rim and impregnation may result. If the rubber
+pessary has been properly fitted, and _it is not porous_, the protection
+should be complete; but if, by any accident, spermatazoa should get beyond
+the rubber pessary, they will be destroyed and tangled in the melted
+suppository--provided, of course, that a suitable suppository has been
+used. It is all a question of getting the right articles to begin with and
+using them intelligently. But there is this chance--a bare chance--of
+accidental impregnation, and we want to eliminate all chances, if
+possible. Assuming the rubber pessary fits properly, as it will if
+skilfully selected and applied in the first instance by a competent
+medical practitioner, then the seminal fluid must remain in the lower part
+of the vaginal passage. An hour or two after intercourse, or next morning,
+this seminal fluid can all be washed away by the use of syringe and bidet.
+It is far better to sit over the bidet and syringe in that position than
+to squat down over a basin--an uncomfortable and unsuitable position for
+douching, because the walls of the vagina in that position may be pressed
+hard together. The fluid should be retained in the vagina for a minute or
+two, by pressing the flange of syringe closely against the orifice of the
+vagina. _After syringing, but not before_, the rubber pessary should be
+removed (to be washed with soap and water, dried carefully, and put away
+till required again), and immediately after removing the rubber pessary it
+is a good plan to facilitate the ejection of the surplus fat of the
+suppository by urinating and re-syringing. It is quite easy for a woman to
+insert and remove these rubber pessaries for herself as occasion requires,
+provided that whilst inserting and removing the pessary she has placed her
+body in a suitable posture--say, lying on the back with knees drawn up,
+sitting on bidet, or standing with one foot on a chair, or whatever other
+position she finds suitable. A doctor's help is needed only when first
+selecting the right size of pessary. The pessaries are made in ten
+different sizes, each size being numbered, and the right size can always
+be obtained on order. No harm may come from wearing the pessary for a day
+or two, but it is highly desirable as a matter of cleanliness and
+otherwise to remove the pessary in the morning when performing the sexual
+toilet. The pessary should, of course, never be worn during the menstrual
+period. A good rubber pessary should last from three to four months, and
+it should be tested occasionally by filling it with water to see that
+there is no hole in it. If it has been fitted shortly after a miscarriage
+or confinement, refitting is desirable at the end of a few months. But in
+normal circumstances refitting is not necessary.
+
+[Illustration: DIAGRAM 5.--Scale: One-sixth actual size.]
+
+[Illustration: DIAGRAM 6.
+
+Two FORMS OF SUPPOSITORIES. ACTUAL SIZE.
+
+These melt rapidly after introduction and provide a pool of antiseptic
+fluid around mouth of womb.]
+
+[Illustration: DIAGRAM 7.
+
+COVERED SPIRAL SPRING RUBBER PESSARY. SEEN IN PROFILE.
+
+It is understood that this is circular. The thickened rim retains this
+circular shape by means of enclosed spiral spring when the pessary is in
+position. To insert conveniently, the thumb and forefinger are placed on
+opposite sides of rim, and the spring pressed into a long oval shape.]
+
+5. _Antiseptic Douching._--If antiseptics of any kind are used, such as
+lysol, they should always be used in _very very weak solutions_, and
+should be varied from time to time. There is no necessity ordinarily to
+use anything but plain warm water, with perhaps a little table-salt in it,
+for internal cleansing, and soap and water for external cleansing; then
+dry parts carefully. But some women prefer a weak antiseptic vaginal wash,
+as they do a weak antiseptic mouth wash. If a woman is unfortunate enough
+to be married to a man liable to infect her, then she should follow the
+same practice as detailed here (every effort, of course, being made for
+her husband to be cured as soon as possible), and she should use a
+_special suppository_, as prescribed by her doctor or otherwise
+authoritatively recommended, and should douche and urinate _immediately
+after each sexual connection_. She should also, before douching with weak
+disinfecting lotion, wash thoroughly--internally and externally--with
+suitable soap and water. This will certainly help to prevent infection in
+the vagina and elsewhere. The rubber pessary and the suppository will give
+her a very real measure of protection against the worst of all forms of
+infection, viz., uterine and ovarian. She can also protect herself against
+infection in the female urethra--that is, the passage from the bladder--by
+urinating _immediately after each connection_, as advised. A good deal of
+nonsense is still talked by some medical practitioners about the alleged
+harmfulness of douching. The same kind of distracting and misleading
+statements were made a few years ago regarding antiseptic mouth-washes,
+which were similarly condemned. Fortunately, we are passing out of these
+dark ages! Soon it will be regarded as quite as natural and necessary and
+desirable to cleanse the genital passages as to rinse out the mouth or
+wipe the nostrils.
+
+It is important to remember that the "_personal equation_" counts for
+something in choosing a disinfectant, some substances suiting one person
+and some suiting others. "One man's meat is another man's poison." It is
+also very desirable to "_ring the changes_" by using, say, lysol one day,
+something else the next, and so on. Using three or four simple
+disinfectants alternately on different days of the week tends to make the
+disinfectants less irritating and more efficacious, as well as adding a
+fresh interest to the toilet performance. On this and other points
+_personal instruction_ is far the best--provided you can find a good
+instructor. Every man and every woman should seek an opportunity of
+learning, from competent authority, precisely what to do in the matter of
+prevention, and what it all means. Reading books is all very well, but
+personal tuition as well is a great advantage.
+
+
+SUMMARY.
+
+Finally, the following briefly summarises the recommendations for women:--
+
+1. _Before Intercourse, Wash and be Clean._--Insert soluble suppository,
+and then place rubber pessary in position, concave side downwards. This
+will slip up more easily if slightly soaped. No harm can possibly come
+either to husband or wife from these appliances, and neither party will be
+conscious of the presence of the occlusive rubber pessary (some other
+kinds of rubber pessary have not these advantages). The pessary can be
+inserted some hours before intercourse, and need not be removed till some
+hours afterwards. _The rubber pessary should not be worn continuously._ If
+you have mislaid the rubber pessary, a small sponge, a piece of clean
+cotton-wool, or even a piece of soft tissue paper can be used. Native
+women in different countries use seaweed, moss, sponge, etc., and Japanese
+women use rice-paper. But these articles are not so clean or effective as
+the occlusive rubber pessary. If sponge or cotton-wool is used, it should
+be saturated in contraceptive lotion or smeared with contraceptive
+ointment before insertion. But always remember--the rubber pessary is
+cleanest and safest.
+
+2. _After Intercourse._--Douche next morning (or earlier), remove rubber
+pessary, wash and dry it and put it away slightly powdered. Where there is
+any chance of venereal infection, the woman should urinate _immediately_
+after _each_ connection, wash with soap and water, and then _at once
+douche with weak and warm disinfecting lotion_. If medically directed, she
+should also use a little calomel ointment for anointing parts that have
+been touched in any way.
+
+3. _Daily._--Cultivate in yourself and in the members of your household
+habits of sexual cleanliness. _Wash and be clean._ Apply this to all the
+openings of the body, but in particular to the vagina, urethra and anus,
+which should all be cleansed night and morning. This practice is not
+simply cleansing and refreshing, but it is preventive of many forms of
+disease, such as piles, etc., etc., and
+
+4. Always remember that the spread of this kind of knowledge has been made
+possible by the long and patient efforts of hundreds of doctors, many of
+them unknown and forgotten, and that women will best be able to apply this
+knowledge efficiently by working in loyal co-operation with medical
+practitioners who have made a special study of these matters.[H]
+
+[Footnote H: The chief pioneers in teaching Birth-Control in England were
+Mrs. Annie Besant, Mr. Charles Bradlaugh, and Dr. Drysdale, Senior.]
+
+
+DIGEST OF BEST PREVENTIVE PRECAUTIONS.
+
+_Before Connection._
+
+1. Douche with warm water or weak antiseptic
+lotion (warm).
+
+2. Insert suitable suppository.
+
+3. Place rubber pessary in position
+
+_After Connection._
+
+4. Douche.
+
+5. Remove rubber pessary. (Urinate to facilitate
+ejection of surplus fat.)
+
+6. Douche and dry parts.
+
+The use of rubber pessary does _not_ do away with desirability of
+douching, but it does enable the woman to douche at her own convenience
+with safety.
+
+
+ANTISEPTIC LOTIONS.
+
+Dr. K.R.D. Shaw, of 144, Harley Street, London, W.1, who has had a very
+wide experience of "prevention" in different parts of the world during the
+last twenty-five years, has named the following as suitable disinfecting
+lotions:--
+
+    Half a teaspoonful of Lysol in 5 pints of warm water;
+_or_ One teaspoonful of Sanitas       "          "
+_or_ One quarter teaspoonful of Bacterol         "
+_or_ 2 grains of Sulphate of Copper   "          "
+
+N.B.--Where there is grave danger of venereal infection, it is an
+excellent additional precaution to douche first with soap and water, and
+douche again with antiseptic lotion. The sooner this is done the better.
+
+If all or most of these hygienic measures are widely made known to women,
+it can rightly be claimed that women have been released from the twin
+terrors of unwanted pregnancy and venereal infection, which are at the
+present time ruining their marital health and happiness in so many cases.
+Even if _some_ only of these measures are adopted, the nation as a whole
+cannot fail to benefit mentally, morally and physically. The success of
+the measures, of course, depends to some extent on their being taken _in
+time_, but in this, as in many other directions, the old proverb holds
+good: _Better late than never._
+
+
+
+
+II.--PRACTICAL METHODS OF PREVENTION.--(_Contd._)
+
+B. FOR MEN:
+
+
+Marriage cannot be made safe, of course, so long as men are permitted to
+contract venereal diseases, and spread them. Early marriage will greatly
+lessen the chances of this; tolerated houses under _effective_ medical
+supervision (such as we had in Paris during the War)[I] would enormously
+lessen the chances of infection, even where marriage was delayed or
+interrupted; prophylactic depots where disinfection was properly applied,
+_and efficiently taught on request_, would be invaluable; but it is at
+present from self-disinfection, properly understood and efficiently
+applied, that the community can hope for the greatest and most immediate
+gain in sexual cleanliness.[J] The following were the directions I gave
+the Anzacs during the war, distributing these with prophylactics for men
+and for women (the directions for women being printed in French and
+English); this action was endorsed by all the leading British, American
+and French military and medical authorities, from the Commanders-in-Chief
+downwards, and the effort undoubtedly saved many thousands of men from
+damage and ruin:--
+
+     "AVOID INFECTION.
+
+     "If you become infected with V.D., the fault is really your own.
+     Either do not risk infection at all, or, risking infection, take
+     proper precautions. These are quite simple. If you take the
+     following precautions _without delay_ you are very very unlikely to
+     contract disease:--
+
+     1. Use vaseline or some other grease (such as calomel ointment)
+     _beforehand_, to prevent direct contact with the source of
+     infection.*
+
+     (* Note: Any personal discomfort or unpleasantness grease causes is
+     counteracted by the woman's having douched beforehand, as should
+     always be done for the sake of cleanliness. A mere film of grease
+     is sufficient to fill up pores of the skin, cover over abrasions,
+     and prevent penetration of microbes, and it greatly facilitates
+     subsequent cleansing.)
+
+     2. Urinate _immediately_ after _each_ connection to wash away all
+     infective material, and to prevent the invasion of the urethra by
+     the microbes of V.D.
+
+     3. Wash thoroughly with soap and water, because ordinary soap is
+     destructive to germs--of syphilis and of gonorrhoea--and bathe
+     parts with weak solution of pot. permang.
+
+     You had far better carry a blue-light outfit with you as a "town
+     dressing," in the same way as you would carry a "field dressing."
+     If you cannot get an outfit, carry a tiny bottle of pot. permang.
+     lotion and a scrap of cotton wool. If you swob yourself _carefully_
+     with this, you will not become diseased. Remember always _it is
+     delay that is dangerous_. If there has been delay, use a syringe
+     sufficiently large for the contents to flood the urethra and
+     slightly distend it, so that every nook and cranny is cleansed.
+
+     Whatever you do, make certain of _going home clean_. Be sure of
+     your health and doubly sure before you embark. While you are in the
+     army and on this side of the world you can be cured easily and
+     privately. If you go home infected, there will be embarrassment and
+     expense to yourself and _great danger_ to the women and children
+     you love.
+
+     _Get cured NOW._" (Paris, April, 1919).[K]
+
+[Footnote I: The following is taken from a paper read by Captain H.L.
+Walker, Canadian Medical Service, O.C. Report Centre (British), Paris, at
+Conference on V.D., organised by the American Red Cross in April, 1918:--
+
+     "Speaking in regard to licensed houses, Captain Walker said that he
+     _had not found one case of venereal disease_ contracted in a
+     licensed house in the City of Paris, and he could only suppose that
+     the people who were responsible for putting the licensed houses in
+     Paris out of bounds knew nothing at all about the real facts of the
+     case.... In the licensed houses in the City of Paris, during the
+     year 1917, _only five cases of venereal disease_ were contracted;
+     and in 1918, up to April 20th (the day he was speaking), _there had
+     not been one case of venereal disease contracted in a licensed
+     house in the City of Paris_. But out of 200 women arrested on the
+     streets of Paris during the month of April, _over twenty-five per
+     cent. were found to be infected with venereal disease_. In the
+     months of November and December, 1917, the French authorities had
+     made a round-up on one boulevard of seventy-one women, of whom
+     _fifty-five were infected with venereal disease_; a few days later
+     the French authorities repeated the same procedure on another
+     boulevard; something like _one hundred women_ were arrested, _and
+     ninety-one per cent. were infected with venereal disease_."--p.
+     134, _Public Health_ (England), September, 1918.
+
+I supervised a tolerated house in Paris for over twelve months
+(1918-1919), and had no cases of disease either among the women or the
+men. The women attended from 2 p.m. to midnight and resided in their own
+homes.--E.A.R.]
+
+[Footnote J: Among the first medical men in Great Britain to recognise the
+importance and effectiveness of self-disinfection was Mr. Frank Kidd,
+M.A., M.Ch. (Camb.), F.R.C.S. (Eng.), etc., of the London Hospital. A full
+statement of his evidence before the Royal Commission on Venereal Diseases
+is given in Mr. Kidd's book, "Common Diseases of the Male Urethra"
+(published by Longmans, Green and Co., 39, Paternoster Row, London, etc.,
+in 1917). The diagram of male organs of generation I have used on page 36
+was taken in outline from Mr. Kidd's frontispiece, and during the war I
+found all the illustrations he gave most helpful with the soldiers,
+although the book itself was written for the purpose of enabling doctors
+in outlying districts to treat patients on modern lines with success. Mr.
+Kidd designed prophylactic tubes, which have been sold in England on his
+order for more than fifteen years. He tells me they have been used all
+over the world by his patients, and that as far as he can ascertain "_they
+have never failed, when used properly and intelligently_."--E.A.R.]
+
+[Footnote K: Since this was written, a large number of experiments have
+been made with the single treatment tube, containing an ointment
+destructive of all forms of venereal disease microbes, whether used before
+or after connection. The Pennsylvania Department of Health is within
+measurable distance of finding a solution of this problem--the production
+of a cheap, portable, easily applied and thoroughly efficient
+self-disinfecting ointment.--E.A.R.]
+
+It was clearly proved that so long as men took these simple precautions
+(which I always explained _personally_) they were very unlikely to
+contract disease; most cases of disease came from multiple connections
+with the women of the cafes, etc. It was difficult to impress on ordinary
+men's minds the fact that _each and every connection was a danger_; that
+the danger of infection began immediately there was any contact, and that
+it continued until disinfection, and was renewed as well with each fresh
+connection during the night. If the danger had continued for several hours
+in this way, the men were told to go to the medical depot or report to a
+doctor as soon as possible. When they did so they were saved from disease
+in the vast majority of cases, even up to twenty-four hours afterwards or
+a little longer.[L]
+
+[Footnote L: In 1915-1916 Colonel Sir James Barrett, then A.D.M.S. of the
+Australian Force in Egypt, had successfully applied prophylaxis, but
+unfortunately he was invalided for a time to England in November, 1916,
+and with the evacuation of the Dardanelles there was a severe outbreak of
+v.d. in Egypt. Prophylaxis was then steadily applied during 1917 by
+Colonel Sir James Barrett and others, and at the end of 1917 v.d. had been
+reduced to small proportions. In December, 1917, Colonel P.G. Elgood, Base
+Commandant of Port Said, wrote:--
+
+"Fortunately, however, at this stage, I came into contact with Colonel Sir
+James Barrett, K.B.E., R.A.M.C, and Miss E. Rout, New Zealand Volunteer
+Sisterhood. The first suggested that the solution of the problem would not
+be found in police measures or in medical examination, but in prophylaxis;
+while the second, in correspondence relating to her own experiences gained
+in England, encouraged me to advocate this remedy."
+
+The successful results of the Port Said efforts are quoted in full by
+Colonel Sir James Barrett in his book, "A Vision of the Possible" (Lewis),
+and Colonel Barrett had early in 1917 sent me to London the following
+tremendously valuable letter of advice and warning:--
+
+     "I suppose my instinct is rather more in the moral direction than
+     many people, but I recognise, as you will see from these articles
+     (published by _Lancet_), that it is by direct prophylaxis, and
+     direct prophylaxis alone that we are likely to get rid of this
+     abomination. I should never in any campaign exclude all the
+     additional aids--proper soldiers' clubs, such as I have established
+     in Egypt, the influence of decent women, and the one hundred and
+     one factors that go to make a decent and reputable life; but you
+     have, in the long run, to recognise the fact that a percentage of
+     men are certain to seek women who are prepared to cater for them.
+     If the steps indicated are taken, the proof is absolute that the
+     disease can be practically extirpated and without great difficulty.
+     The failure of prophylaxis depends on two factors--firstly, it
+     requires someone charged with responsibility, earnestness and high
+     character to explain to men precisely what they are doing and what
+     it means; and secondly, prophylaxis is of very little use to
+     drunken men. My experience has been that when these precautions are
+     properly used venereal disease may disappear."
+
+That proved to be exactly my own experience in the army. Failures in the
+army were due to the absence of proper personal instruction of the men and
+the laxity of control, and these conditions can always be assumed to exist
+in any army having a high v.d. infection rate.--E.A.R.]
+
+Nevertheless, the people who would put sacerdotalism before science, and
+the still meaner minds who would substitute legality for morality, raised
+storms of objection to my work, in the midst of which came a few strong,
+clear calls of understanding and encouragement.
+
+One Scotch padre wrote me in 1918:--
+
+     "It is a magnificent adventure for a woman to go practically alone
+     on the very edge of things, and I salute you, and congratulate you,
+     and wish you _God-speed_."
+
+An old family doctor, then with a colonial ambulance, wrote:--
+
+     "Many women ... will owe their health and happiness to you, and not
+     a few will be indebted to you for their lives."
+
+The editor of the Sydney _Bulletin_ (Australia) was continually publishing
+helpful articles and paragraphs--after my letters and articles were
+censored;[M] and from Dr. W.H. Symes, of Christchurch, New Zealand, I
+heard by personal correspondence steadily and wisely all through the war.
+Much later came the following tribute, in a most valuable book written by
+Sir Archdall Reid and Sir Bryan Donkin ("Prevention of Venereal Disease,"
+published by William Heinemann (Medical Books) Limited)[N]:--
+
+     "Sir Bryan Donkin's letter, which appeared in _The Times_, in
+     January, 1917, and other communications which he published as
+     opportunity offered, brought him an introduction from Sir J.W.
+     Barrett, M.D., then serving as A.D.M.S. with the Australian Force
+     in Egypt, to Miss Ettie Rout, who, by profession a journalist, had
+     come with the Australian and New Zealand Forces with the object of
+     ameliorating, as far as possible, the hardships of war. She had
+     been horrified by the pestilence of venereal disease which broke
+     out among the troops in Egypt, England, and elsewhere, and, with
+     extraordinary resolution and courage, had embarked almost
+     single-handed on a campaign of prevention. She furnished Sir Bryan,
+     and later myself also, with much valuable information, and for her
+     own part fought the battle most strenuously--living among the men,
+     lecturing, finding and instructing lecturers, providing
+     disinfectants, importuning authorities, writing most trenchant
+     letters, establishing medical clubs in England and France, and the
+     like. I think that when the names of those who opposed her are
+     forgotten, the memory of this brave lady will still be green among
+     the descendants of the valiant men for whose welfare she
+     struggled"--p. 176-177.
+
+[Footnote M: The _New Zealand Times_ daily newspaper published my first
+article and was severely reprimanded by the New Zealand Government for
+doing so, and all New Zealand newspapers were then prohibited from
+publishing any further articles relating to V.D. in the New Zealand
+Forces.--E.A.R.]
+
+[Footnote N: See Publishers' notice.]
+
+
+ALCOHOLISM.
+
+It should be noted here that another great difficulty we had was to make
+men _beware of the dangers of drink_. A man who is in liquor is much more
+liable to contract venereal disease than a man who is sober. Alcohol
+increases sexual desire, lessens sexual ability, and lowers the sense of
+responsibility. Hence, drunkenness, immorality and disease go hand in
+hand: a dreadful three. But more than this. The drunken man takes much
+longer over the sex-act, thereby prolonging the risk of disease, and he
+runs risks which he would rule out instantly if the fumes of alcohol had
+not changed the tawdry girl into the glittering fairy. Worse than all, he
+neglects to apply disinfection properly and _promptly_--he falls asleep or
+forgets all about it till _too late_. Men who are determined to have a
+"night out" should use calomel ointment (or some other substitute) _before
+they start_; and if they have been in liquor they should disinfect
+instantly when they recover their sober senses. Generally speaking, _an
+ounce of calomel is worth a ton of salvarsan_.
+
+As with young men, so with young girls: a few glasses of wine taken at a
+supper or a dance--and the first downward step is taken, not because any
+wrong was intended, but the simple actualities of sex were unknown, and
+the stimulant took advantage of the ignorance that is miscalled innocence.
+This kind of thing will continue till the older generation realise that
+morality depends--not on the maintenance of ignorance and the fear of
+disease, but on the spread of knowledge and the promotion of virtue.
+
+It is not morality, but caution, that is developed by fear, and in this
+case caution is counteracted by the practical experience that many men are
+immoral without becoming diseased. One man commits many immoral acts and
+suffers not at all; another man becomes syphilitic by yielding for the
+very first time; the penalty is purely fortuitous. There is no necessary
+connection at all between immorality and disease. The dangers of sexual
+intercourse are due to dirt and promiscuity rather than to immorality, and
+in part to the physical conformation of the individual. Virtue has far
+deeper and more substantial foundations than the mere gusts of fear. It is
+founded on necessary and responsible guardianship of the very gates of
+life.
+
+
+
+
+III.--MEDICAL FORMULĘ.
+
+
+The medical formulę for venereal disease preventive ointments for men, and
+venereal disease preventive suppositories and ointments for women, should
+be decided upon, after thorough investigation and test, by the Departments
+of Public Health, and none other should be permitted to be sold. Printed
+directions should be issued, duly authorised by the Departments of Public
+Health, and no other directions should be supplied to the public with the
+venereal disease preventives. In these respects, to the best of my belief,
+the Division of Venereal Diseases of the Pennsylvania Department of
+Health, co-operating with the United States Public Health Service, will
+play the leading part; is, indeed, already doing so. Under the direction
+of Dr. Edward Martin, Commissioner of Health, and Dr. S. Leon Gans,
+Director, Division of Venereal Diseases, specimen tubes are tested and
+approved (with directions and other printed matter)[O] by the Health
+Laboratories of the Department; and certificates are issued to
+manufacturing chemists authorising the manufacture of ointments made in
+accordance with approved formulę. Requests are made officially by the
+Department to retail chemists and druggists to sell, and to medical
+practitioners to recommend, suitable venereal disease preventives to the
+general public in a proper manner. In time it will probably be found
+advisable to authorise only a standard type of tube--preferably the metal
+tube with elongated nozzle and expanded metal cap--filled with one simple
+self-disinfecting ointment.
+
+[Footnote O: In some cases the printed matter used by the drug companies
+also bears the "_Official Endorsement_" of the local "_Social Purity
+Association_" stamped upon it in indelible ink--a magnificent tribute to
+the educative work of the Public Health Department, as well as to the
+enlightened courage of the Social Purity Associations.
+
+The following is quoted as sample of directions authorised in U.S.A.:--
+
+"The use of this package is not to be construed as a licence to exposure.
+Pro-Ven, the original preventive. _The only sure_ way to prevent
+infection: _Do not expose yourself._ All exposures should be considered as
+infections, for 90 per cent. of all "easy women" are infected. By proper
+use of the contents of this package disease may be prevented, as the
+action upon the germs is as effective as can be secured by the latest
+scientific knowledge; if exposed, _use within two hours_. After contact:
+1st. Urinate. 2nd. Remove the cap from tube; take organ in the hand,
+holding the canal open; insert tip of the tube and squeeze half of the
+contents into the canal. 3rd. Squeeze the remainder on the outside of the
+organ, rubbing well into the creases and folds under and back of head and
+clear to the body. 4th. Leave ointment on three or four hours. Remember:
+It is best to use _Pro-Ven_ immediately after exposure; never delay more
+than two hours if possible. _Pro-Ven_ is not a cure--it is designed to
+keep men from getting disease; it can be used as a lubricant and
+preventive both before and after exposure. _Pro-Ven_ is harmless and will
+not cause pain or injury to the sexual organs. Insist upon having
+_Pro-Ven_. At all good druggists, or directly by mail, 25 cents a tube; 5
+tubes, $1.00. Booklet mailed free upon request. The Pro-Ven Laboratories,
+Washington, D.C. This product has been tested and approved by the
+Pennsylvania State Department of Health Laboratories."
+
+In addition to _Pro-Ven_, the following proprietary tubes of
+self-disinfecting ointment have, to my knowledge, been authorised by the
+Department of Health, and samples were sent to me:--
+
+_Procaline_, manufactured by the Hawthorne Drug Speciality Co.,
+Inc., 88-90, Reade Street, New York City.
+
+_Cargenios_, manufactured by H.K. Mulford Company, Philadelphia.
+
+_Andron_, manufactured by Andron Hygienic Co., 120, W. 32nd St.,
+New York City.
+
+_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), potassium 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 relationship 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 sexes. Their
+abolition was the worst blow ever struck at marriage. Fortunately, their
+main principles we are now beginning to re-enact in various Sexual 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 sexual 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 Cassidente 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 shilling, under the title 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, sex 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 sexual 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--sex 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 vagina. 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 sexual 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 vagina
+faster than it can flow out--hence distension of walls of vagina 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 washing 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 sexual 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 relationship 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 practitioners 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.
+
+_Bidets and Syringes._--Syringes are easily procurable, but bidets in
+England at present are sometimes difficult to obtain. Good strong enamel
+bidets can be obtained from Messrs. E. Lambert & Son, of 60, Queen's Road,
+E.8., and they also keep the contraceptive suppositories made by Mr.
+Harman Freese in accordance with medical directions mentioned in Foreword.
+
+_Soluble Suppositories (for women)._--These are now being manufactured by
+Mr. Harman Freese, of Freese & Moon, 59, Bermondsey Street, S.E.1, from
+whom they can be obtained. These suppositories are disinfective as well as
+contraceptive, but they are at present sold for the ordinary purposes of
+birth-control.
+
+_Sanitary Tubes (for men)._--These tubes are also manufactured by Mr.
+Harman Freese, of Freese & Moon, 59, Bermondsey Street, S.E.1, in
+accordance with medical directions mentioned in Foreword. It is quite
+possible to manufacture an ointment which, if properly used, would be a
+preventive of all forms of venereal disease. The sale of such an ointment
+is authorised by the State Health Department of Pennsylvania.
+
+_Information_ as to the medical prevention of venereal disease may be
+obtained from the Hon. Sec., Society for the Prevention of Venereal
+Diseases, 143, Harley Street, W.1. Information regarding birth-control
+has been made available to adults in England for the last half-century by
+Dr. Drysdale, Sen., and his family and supporters, through the Malthusian
+League, whose present address is 124, Victoria Street, London, S.W.1.,
+and these pioneers have made a most self-sacrificing effort for the
+benefit of poor women by establishing a welfare centre at 153a, East
+Street, Walworth, London, S.E.17, where free advice is given in
+birth-control and sexual hygiene, and where medical supplies are available
+at nominal prices. This centre is supported entirely by voluntary
+subscriptions and at present stands in dire need of financial
+help.[T]--E.A.R.
+
+[Footnote T: At my personal request the publishers have agreed to name the
+firms and societies mentioned in Appendix II. These notifications are made
+gratis for the benefit of the medical profession and the general public,
+and not by way of advertisement.--E.A.R.]
+
+
+
+
+NOTE.--Every thoughtful woman is urged to buy and study carefully the
+great work entitled: "PREVENTION OF VENEREAL DISEASE," by Sir Archdall
+Reid, K.B.E., M.B., C.M., F.R.S.E., with an introductory chapter by Sir
+Bryan Donkin, M.D., F.R.C.P., in order that she may understand the nature
+of the problems involved and the strength of the opposition to
+_cleanliness_.
+
+
+_This book is endorsed by the Society for the Prevention of Venereal
+Disease and contains the evidence and arguments on which the Society bases
+its policy, and is addressed to all who would prevent venereal diseases in
+themselves or in the community._
+
+
+Children may be taught any system of morals--sexual or other; Christian,
+Mahomedan, Hindoo, Papuan, or other. They are intensely imitative and
+acquire a bias towards local ideas of right and wrong through association
+with intimate companions. A bias once acquired tends to persist. For that
+reason parents choose good companions and schools. On the other hand, it
+is difficult or impossible to convert "hardened sinners," for example,
+adult non-Christians. Children, therefore, may be really taught; adults,
+as a rule, can only be preached at. Any man may test the truth of all this
+by examining his own consciousness. Would any amount of preaching cause
+him to change his present ideas of right and wrong? As little can he alter
+the bias of other men. As the twig is bent so the tree grows.
+
+In various times and places, almost everything from promiscuous sexual
+intercourse to absolute abstinence from all intercourse has been held
+holy, or permissible, or damnable. Even among Christians the widest
+differences have prevailed as regards the local and contemporary tone.
+Among them, especially among the English speaking peoples, a convention
+forbids the familiar discussion of sexual matters between children and
+adults. This convention may be right or wrong. In any case it exists, and
+is likely to persist for ages. But a knowledge of sex is traditional among
+boys, and to some extent among girls of the school age. For good or evil,
+therefore, children are the real teachers of sexual morals in England.
+Children deal with the impressionable age and give the early bias. Adults
+stand aside, and teach only extreme reticence. The discussions of boys are
+often obscene. As a consequence vast numbers grow up with the idea that
+unchastity is a gallant adventure, or, at worst, only a peccadillo. Even
+in old age such men look back to past intrigues with satisfaction. After
+marriage another tradition, or bias, also taught by English boys, comes
+into action--the tradition to keep the plighted word, to "play the game."
+The great majority of married Englishmen, therefore, are chaste.
+
+Judging from history, the world, and in particular England, is not
+more--or less--immoral to-day than at any time during the last 2000 years.
+During all that time children have taught and adults have preached.
+Doubtless there have been many campaigns of purity in the past--mere
+campaigns of preaching to adults. They were ineffectual and are forgotten.
+Epochs of licence have almost invariably followed epochs of austerity.
+Modern campaigns of purity never arise except as consequents on medical
+attempts to prevent venereal disease, and always cease when the attempt to
+procure sanitation has ceased. In effect, they have been merely campaigns
+to secure the poisoning of sinners and their victims.
+
+The extent of current immorality may be judged from the prevalence of
+venereal disease. The Royal Commission of 1913-16 found that ten per cent.
+of the urban population suffered from syphilis. Eighty per cent. of the
+population of the United Kingdom is now urban, and gonorrhoea is six or
+seven times as prevalent as syphilis. It follows that at least every other
+person in the Kingdom has suffered from venereal disease. Probably not a
+family has escaped infection. In proportion to its prevalence syphilis is
+not very deadly, yet it has been reckoned as the fourth killing disease.
+The victims of gonorrhoea are incalculable. Venereal diseases fill our
+hospitals, asylums, and workhouses. They are the principal causes of heart
+disease, apoplexy, paralysis, insanity, blindness in children, and of that
+life of sterility and pain to which so many women are condemned. It is
+said that chastity is the only real safeguard against venereal disease.
+But this is always said by people who have never stirred a finger to teach
+chastity, but who have only preached it. At any time there are at least a
+million of perfectly innocent sufferers, principally women and children,
+in the United Kingdom.
+
+During the war a disloyal faction in every Dominion endeavoured to prevent
+the sending of help to the Mother Country. A principal cry of this faction
+was, "Do not let us send our clean lads to that cesspool, England."
+England is more than the world-cesspool. Since Englishmen are the greatest
+travellers, she has been the principal source of infection for the world.
+At one time during the war the Australasian Governments threatened to
+withdraw their forces unless measures were taken to protect them.
+
+When the German offensive was impending a sanitary method was published,
+so effective that the venereal rate was reduced from 92 to 15 per thousand
+per annum. The Government proposed to bring the method into general use in
+the Army, but was prevented by influences which preferred to see the
+country poisoned and the British Army defeated. While the opponents of
+sanitation sat snugly at home hundreds of thousands of British soldiers
+were killed or maimed, enormous material was lost with territory which
+other hundreds of thousands of brave men had died to win, the war was
+prolonged, thousands of millions were added to the National Debt, and half
+trained boys and elderly fathers of families were hurried into the firing
+line. At that time there were in hospitals or in depots, convalescent from
+venereal disease, enough fully-trained allied soldiers to furnish, not an
+army corps but a great army, complete almost from G.O.C. to trumpeter.
+
+Fear of disease does not prevent immorality, as may be judged from the
+immense prevalence of venereal disorders. But it does drive baser
+characters to the pursuit and seduction of "decent" girls. In this way
+nearly all prostitutes begin their careers. Prostitutes are much more
+diseased than other women, who, though often diseased, are seldom
+suspected of disease. Yet, since it has been found statistically that
+three out of four men acquire their maladies from amateurs, it is manifest
+that prostitutes only hang on the fringe of a vaster immorality. Men, who
+know more of these diseases than women, are, on the average, much less
+chaste. Medical students who know most are not more moral than other men.
+Plainly venereal diseases are causes, not preventives, of immorality.
+Nothing, therefore, is gained from their prevalence except a flood of
+death, disability, and misery, which falls alike on the just and unjust.
+
+During the war Sir Archdall Reid, employing very simple means, reduced the
+incidence of disease among the large body of troops in his charge almost
+to the vanishing point. He could not make them more moral, he did not make
+them less moral, but at any rate he preserved their services for the
+country in its hour of need. And he preserved their future wives and
+children from unmerited death and suffering. Other doctors were equally
+successful. The town authorities of Portsmouth and many other boroughs are
+about to employ these methods for the prevention of disease among the
+civil population. This book describes them and tells the story of the
+fight against a wicked and cruel fanaticism. Its policy is endorsed by
+many of the leading men and women in the Kingdom--members of both Houses
+of Parliament, town authorities, doctors, authors, sociologists and
+others.
+
+     +--------------------------------------------------------------+
+     |                PREVENTION OF VENEREAL DISEASE                |
+     |   By Sir ARCHDALL REID, K.B.E., M.B. With an Introduction    |
+     |                  by Sir BRYAN DONKIN, M.D.                   |
+     |                     Crown 8vo, 15s. net.                     |
+     |                                                              |
+     |                    SEX-PROBLEMS IN WOMEN                     |
+     |         By A.C. MAGIAN, M.D. Demy 8vo, 12s. 6d. net.         |
+     |                                                              |
+     |                     THE SEXUAL QUESTION                      |
+     |    A Scientific, Psychological and Sociological Study. By    |
+     |            Dr. AUGUST FOREL. Royal 8vo, 25s. net.            |
+     |                                                              |
+     |                 THE SEXUAL LIFE OF OUR TIME                  |
+     |    In its Relation to Modern Civilization. By IWAN BLOCH,    |
+     |                  M.D. Medium 8vo, 25s. net.                  |
+     |       Sold only to the Medical and Legal Professions.        |
+     |                                                              |
+     |                   THE SEXUAL LIFE OF WOMAN                   |
+     |     A Physiological, Pathological and Hygienic Study. By     |
+     |       Professor HEINRICH KISCH. Super royal, 25s. net.       |
+     |       Sold only to the Medical and Legal Professions.        |
+     |                                                              |
+     |                    PSYCHOPATHIA SEXUALIS                     |
+     |   With special reference to Antipathic Sexual Instinct. A    |
+     |     Medico-forensic study by the late Dr. R. VON KRAFFT      |
+     |                 EBING. Royal 8vo, 25s. net.                  |
+     |       Sold only to the Medical and Legal Professions.        |
+     |                                                              |
+     |                                                              |
+     |           WILLIAM HEINEMANN (Medical Books) Ltd.,            |
+     |             20, BEDFORD STREET, LONDON, W.C.2.               |
+     +--------------------------------------------------------------+
+
+
+PRINTED IN GREAT BRITAIN BY
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+
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