The number of articles belonging to this category is legion. I need mention a few only: “Security ovals,” containing boric acid, quinine, or citric acid; “little vaginal plugs”; “salus ovula”; Kamp’s anticonceptional cotton-wool plugs; Hüter’s vaginal insufflator “for the malthusian”; Noffke’s tampon-speculum; “spermathanaton”;[731] Weissl’s preservative (a combination of speculum and rubber disc with a steel spring and a cotton-wool plug impregnated with a drug); the “Venus apparatus” (a double rubber ball, the smaller ball filled with “Venus powder” (sic) being introduced within the vagina, whilst the woman herself, at the moment of ejaculation, presses the larger ball lying near to her thighs, whereupon the powder is expelled from the smaller ball into the vagina); the “duplex occlusive pessary” (an occlusive pessary with double walls, perforated with round apertures, containing in its interior boric acid tablets for the purpose of killing the spermatozoa).
It may be that now and again, by some of the means just mentioned, conception may be prevented. But on the whole they are very uncertain; and, on the other hand, it is doubtful if the chemical substances introduced in this way are harmless. It is possible that many peculiar inflammatory conditions of the male and female genital organs may be referred to their use. For example, Blumreich[732] reports the case of a man who, after coitus in which a means of this kind had been used, had an extremely obstinate inflammatory eruption upon the penis.
I take this opportunity of pointing out that the so-called herpes progenitalis, a peculiar vesicular eruption of the genital organs, occurring chiefly in males, which alarms a great many patients, because they regard it as the result of syphilitic infection, is, in the great majority of cases, a perfectly harmless affection caused by some transient irritation.[733]
Besides the above-mentioned methods for the prevention of pregnancy, we have also to consider two radical means of practical malthusianism which belong to the purely medical province, and can only be employed when life and death are involved, when pregnancy and parturition would entail upon the woman severe illness or certain death. These two means are the operative induction of artificial sterility and artificial abortion.
Artificial sterility can be produced by various measures, as by the intentionally effected malposition of the uterus, such as is practised among the indigens of the Malay Archipelago; by section of the Fallopian tubes, as recommended by Kehrer; by the so-called castratio uterina by means of vaporization (the application of superheated steam by the method of Pincus, whereby menstruation is suspended and the uterine cavity is obliterated); and finally by castration proper, the extirpation of the ovaries[734] (oöphorectomy, spaying, Battey’s operation), which was carried out in ancient times by quite savage races, in order to prevent reproduction.[735] In France, theoretically anti-malthusian, but practically through and through malthusian, in the country from which the song originates—
“Ah! l’amour, l’amour!
C’est le plaisir d’un jour
Pour le regret d’ neuf mois.”
[“Ah! love, love!
’Tis the pleasure of a day
For the regret of nine months”]
—it appears, according to recent descriptions,[736] that oöphorectomy is greatly prized by distinguished ladies as a means for the prevention of pregnancy. It is said that there even exist “specialists” for the production of these child-hating “ovariées,” men who undertake this operation at a high fee. In Germany, happily, this radical measure for the prevention of conception is not employed in healthy persons; the operation is performed only in women who are seriously ill, and strictly for therapeutic purposes.
The preventive measures previously mentioned, if we except coitus interruptus and the condom, are all very untrustworthy, as we learn from the extreme frequency of deliberate, artificial abortion in all countries, and among all classes of the population.[737] Artificial abortion is, as is well known, a criminal offence, punishable by a long term of imprisonment for all those concerned, the pregnant woman herself and her accomplices. In the Orient and among savage races, however, abortion is not punishable. Among the civilized nations of Europe artificial abortion is punished; in Germany the mere attempt at abortion is punishable, even though only an imaginary pregnancy is present. That the State must take steps to prevent abortion, as an immoral and unnatural action, is obvious, and this is necessary above all because intentional abortion in so many cases endangers the life and health of women. But in order that such punishment should be reasonable, it is essential that society should work to this end, that the social conditions upon which the frequency of the practice depends should be abolished; society should abandon the artificial defamation of illegitimate motherhood, and should in every possible way work for the improvement of the possibilities of motherhood—should found homes for mothers and for pregnant women, should provide for the insurance of mothers, etc. It is a remarkable contradiction, to which Gisela von Streitberg[738] draws attention, that illegitimate pregnancy is regarded as sinful and shameful: simultaneously the life of the child about to be born is regarded as sacred; whilst this same child, as soon as it is born, is once more regarded as infamous. In fact, to the illegitimate child, in the social morality of our time, which is at once ridiculous and profoundly perverted, there inevitably attaches something despicable and dishonourable. It is right that those who make the procuring of abortion a professional occupation should be severely punished; but, on the other hand, it is doubtful whether it is right to punish mothers, and more particularly the mothers of illegitimate infants, against whom the Criminal Code is especially directed, for artificially inducing abortion. It is, in fact, open to question whether the punishment is even legal. It is well known that according to § 1 of the Civil Code the rights of a human being are said to begin only with the completion of birth,[739] and it is certainly open to question whether the as yet undeveloped human fœtus has any personal rights at all. Without doubt we have to do with a being which has not yet begun to exist, but which is only in process of becoming. Thus, juristically, and from the standpoint of the philosophy of law, the foundation for the punishment for abortion is a very unstable one. Consider, for example, impregnation resulting from rape. Should not the woman concerned have the right to employ any and all means available to her to destroy at the very outset the child thus forced upon her?
The means for the induction of abortion[740] prior to the twenty-eighth or thirtieth week of pregnancy are very various, and may be considered under the two categories of internal and mechanical means respectively. Infallible internal abortifacients do not exist; and almost all abortifacients are dangerous owing to their toxic effects. Those most commonly employed are ergot, ethereal oil of savin (Juniperus sabina), varieties of thuja, yew (Taxus baccata), turpentine, oleum succini, tansy, rue, camphor, cantharides, aloes, phosphorus, etc. Mechanically, abortion may be effected by blows, by violent movements (for example, during coitus), massage, perforation of the membranes, hot injections, steam, manipulations with the finger at the os uteri, the introduction of sounds and other objects through the os uteri, venesection, application of the electric current, etc. With all these practices there is involved great danger of injury, poisoning, infection, rupture and perforation of the uterus, the entry of air into the uterine veins, scalding of the internal genital organs, etc. It is, therefore, not to be wondered at that death so frequently ensues, and that almost always severe illnesses result from the use of these abortifacients.