"Forel compared the use of contraceptive devices to the use of eyeglasses, and it is obvious that, without expert advice, the results in either case may sometimes be mischievous or at all events ineffective. Personal advice and instruction are always desirable. In Holland nurses are medically trained in a practical knowledge of contraceptive methods, and are thus enabled to enlighten the women of the community. This is an admirable plan. Considering that the use of contraceptive measures is now almost universal, it is astonishing that there are yet so many 'civilized' countries in which this method of enlightenment is not everywhere adopted. Until it is adopted, and a necessary knowledge of the most fundamental facts of sexual life brought into every home, the physician must be regarded as the proper adviser. It is true that until recently he was generally in these matters a blind leader of the blind. Nowadays it is beginning to be recognized that the physician has no more serious and responsible duty than that of giving help in the difficult path of sexual life. Very frequently, indeed, even yet, he has not risen to a sense of his responsibilities in this matter. It is well to remember, however, that a physician who is unable or unwilling to give frank and sound advice in this most important department of life, is unlikely to be reliable in any other department. If he is not up to date here, he is probably not up to date anywhere.

"Whatever may be the method adopted, there are certain conditions which it must fulfill, even apart from its effectiveness as a contraceptive, in order to be satisfactory. Most of these conditions may be summed up in one: the most satisfactory method is that which least interferes with the normal process in the act of intercourse. Every sexual act is, or should be, a miniature courtship, however long marriage may have lasted. No outside mental tension or nervous apprehension must be allowed to intrude. Any contraceptive proceeding which hastily enters the atmosphere of love immediately before or immediately after the moment of union is unsatisfactory and may be injurious. It even risks the total loss of the contraceptive result, for at such moments the intended method may be ineffectively carried out, or neglected altogether. No method can be regarded as desirable which interferes with the sense of satisfaction and relief which should follow the supreme act of loving union. No method which produces a nervous jar in one of the parties, even though it may be satisfactory to the other, should be tolerated. Such considerations must for some couples rule out certain methods. We cannot, however, lay down absolute rules, because methods some couples may find satisfactory prove unsatisfactory in other cases. Experience, aided by expert advice, is the only final criterion.

"When a contraceptive method is adopted under satisfactory conditions, with a due regard to the requirements of the individual couple, there is little room to fear that any injurious results will be occasioned. It is quite true that many physicians speak emphatically concerning the injurious results to husband or to wife of contraceptive devices. Although there has been exaggeration, and prejudice has often been imported into this question, and although most of the injurious results could have been avoided had trained medical help been at hand to advise better methods, there can be no doubt that much that has been said under this head is true. Considering how widespread is the use of these methods, and how ignorantly they have often been carried out, it would be surprising indeed if it were not true. But even supposing that the nervously injurious effects which have been traced to contraceptive practices were a thousandfold greater than they have been reported to be—instead of, as we are justified in believing, considerably less than they are reported—shall we therefore condemn contraceptive methods? To do so would be to ignore all the vastly greater evils which have followed in the past from unchecked reproduction. It would be a condemnation which, if we exercised it consistently, would destroy the whole of civilization and place us back in savagery. For what device of man, ever since man had any history at all, has not proved sometimes injurious?

"Every one of even the most useful and beneficial of human inventions has either exercised subtle injuries or produced appalling catastrophes. This is not only true of man's devices, it is true of Nature's in general. Let us take, for instance, the elevation of man's ancestors from the quadrupedal to the bipedal position. The experiment of making a series of four-footed animals walk on their hind-legs was very evolutionary and risky; it was far more beset by dangers than is the introduction of contraceptives; we are still suffering all sorts of serious evils in consequence of Nature's action in placing our remote ancestors in the erect position. Yet we feel that it was worth while; even those physicians who most emphasize the evil results of the erect position do not advise that we should go on all-fours. It is just the same with a great human device, the introduction of clothes. They have led to all sorts of new susceptibilities to disease and even tendencies to direct injury of many kinds. Yet no one advocates the complete disuse of all clothing on the ground that corsets have sometimes proved harmful. It would be just as absurd to advocate the complete abandonment of contraceptives on the ground that some of them have been misused. If it were not, indeed, that we are familiar with the lengths to which ignorance and prejudice may go we should question the sanity of anyone who put forward so foolish a proposition. Every great step which Nature and man have taken in the path of progress has been beset by dangers which are gladly risked because of the advantages involved. We must never loose sight of the immense advantages which Man has gained in acquiring a conscious and deliberate control of reproduction."

THE END.

Transcriber's Note:

Numerous minor typographical errors have been corrected without note. Variations in spelling (e.g. fetus/foetus), capitalization, and hyphenation have not been standardized. Where a misspelling was used five or more times (e.g. umbillical), no correction has been made. No attempt has been made to correct factual errors or poorly constructed sentences.

The following corrections were also made to the text: