Safe Marriage Part 2

[Ill.u.s.tration: Diagram 4]

GENERAL CONDITIONS.

1. _Cleanliness._--s.e.xual control is largely a matter of s.e.xual cleanliness. We must all learn to keep the genital pa.s.sages cleansed in the same way as we keep all the other openings of the body clean. The ears, eyes, nostrils, mouth, a.n.u.s, orifice to the urethra, and the v.a.g.i.n.a should be appropriately cleansed daily. The openings of the body which stand most in need of daily cleansing are the a.n.u.s and the v.a.g.i.n.a, 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 a.n.a.lysed 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-b.u.t.ter. Cocoa-b.u.t.ter 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-b.u.t.ter 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 pa.s.s 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 formulae, 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 subst.i.tuted, 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 v.a.g.i.n.al pa.s.sage 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 v.a.g.i.n.a, straighten out their folds and furrows, and thus let the cleansing and protecting lotion touch every part as far as possible. A movable rubber f.l.a.n.g.e is necessary to act as a stopper at the mouth of the v.a.g.i.n.a, 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 v.a.g.i.n.a 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 v.a.g.i.n.a, 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 pa.s.sage 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 pa.s.s 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. a.s.suming the rubber pessary fits properly, as it will if skilfully selected and applied in the first instance by a competent medical pract.i.tioner, then the seminal fluid must remain in the lower part of the v.a.g.i.n.al pa.s.sage. 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 v.a.g.i.n.a in that position may be pressed hard together. The fluid should be retained in the v.a.g.i.n.a for a minute or two, by pressing the f.l.a.n.g.e of syringe closely against the orifice of the v.a.g.i.n.a. _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 s.e.xual 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 circ.u.mstances refitting is not necessary.

[Ill.u.s.tration: DIAGRAM 5.--Scale: One-sixth actual size.]

[Ill.u.s.tration: DIAGRAM 6.

Two FORMS OF SUPPOSITORIES. ACTUAL SIZE.

These melt rapidly after introduction and provide a pool of antiseptic fluid around mouth of womb.]

[Ill.u.s.tration: 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 v.a.g.i.n.al 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 s.e.xual 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 v.a.g.i.n.a 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 pa.s.sage from the bladder--by urinating _immediately after each connection_, as advised. A good deal of nonsense is still talked by some medical pract.i.tioners 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 pa.s.sing out of these dark ages! Soon it will be regarded as quite as natural and necessary and desirable to cleanse the genital pa.s.sages 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 j.a.panese 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 s.e.xual cleanliness. _Wash and be clean._ Apply this to all the openings of the body, but in particular to the v.a.g.i.n.a, urethra and a.n.u.s, 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 pract.i.tioners 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 s.e.xual 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.