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PART Ⅰ ETHICAL POSTULATES AND PRINCIPLES1

CHAPTER Ⅰ．INTRODUCTION．THE ETHICAL AND THEOLOGICAL ASPECTS．THE STANDPOINT OF THIS STUDY1

Difficulties of the Subject1

Three Groups of probable Readers2

Illusion4

Fiction5

Vital Hypothesis5

Significance of Religion：Ethical and Practical6

Sexual Abstinence if effective must be absolute9

Sexual Starvation10

Condemnation of Prolonged Abstinence within Marriage10

The Large Families of the Past11

Regulation of Reproduction need not be Extreme12

Three to Four Children at intervals of two and a half Years13

Children should be Born before the Mother is thirty-five13

The Roman Catholic Church：Dogma and Codes14

＂Facultative Sterility＂：Capellmann-Bergmann15

Seasonal Diminution of Probable Conceptions16

Noldin17

Gury-Ballerini18

Tempus ageneseos (＂Safe Period＂)18

＂Abruptio Copulae＂before Emission20

Contradictions among Catholic Moral Theologians21

Exodus from the Churches23

Letter of the Bishop of Le Mans24

Attitude of Protestant Theologians28

Wichern28

Knabe30

Weymann31

Failure of Church Guidance to their Flocks33

The Medical Profession has the Duty to Advise35

APPENDICES TO CHAPTER Ⅰ35

Noldin，Original Text35

Noldin，Telch，Gury-Ballerini Original Texts36

Monseigneur Bouvier，Original Text39

The＂Sin of Onan＂42

Quotation from Kirstein44

Quotation from Haug45

Copec46

The Hebrew Faith and Contraception47

The Lambeth Conference47

Quotation from Wichern48

CHAPTER Ⅱ．FAMILY LIMITATION IN ITS NATIONAL，INTERNATIONAL AND RACIAL ASPECTS49

Grotjahn49

The Egotism of the Sexual Impulse49

Harmony of Interests：Individual and Communal50

Difficulties of the Population Problem51

Dangers of Unbalance，Ethnic and Cultural52

Neither Overpopulation nor Depopulation53

The Situation in Contemporary France55

Difficulties of Assimilation55

Dangers to Cultural Level57

Make it advantageous to have Children!59

Position in Western and Central Europe61

Grotjahn＇s View：Minimum of Three Children63

Financial Privileges for Large Healthy Families65

The Housing Problem67

Large-Scale Measures advisable67

Quantity and Quality67

Diminished Numbers affect Quality67

Each Social Stratum should make good its Losses68

Improvement of Quality Imperative68

Wholesome Happy Sex Lives and Births benefit the State68

Summary of Economic Arguments68

APPENDICES TO CHAPTER Ⅱ68

Quotation from Labat68

Quotation from Harmsen69

Quotation from Le Fêvre70

Quotation from Lagneau72

The Number of Children73

The Housing Problem75

Extinction of Intellectual Classes76

Increase of Valuable Racial Elements77

CHAPTER Ⅲ．THE INDIVIDUAL ASPECT OF FERTILITY AND STERILITY IN MARRIAGE79

The Third Corner-Stone of Married Happiness79

Differences between Men and Women in Parental Urge80

The two Groups of Childless Wives80

What Children mean to Men81

Rational or Intellectualized Parenthood83

A Vital Question84

The only Child：Difficulties and Handicaps85

The Best Number：Three or Four87

The only Practicable Method is Contraception88

Unavoidable Disadvantages89

Loss of Complete Spontaneity89

AEsthetic Factors90

Warning against Frivolous and Hasty Decisions91

Psychic Disturbances and Conflicts93

Injury to Specific Erotic Pleasure94

A Serious Matter：to be Settled seriously96

Reverence for Life96

Sense of Responsibility and Duty of Steadfastness97

APPENDICES TO CHAPTER Ⅲ98

Quotation from Reich98

Economies of Parenthood98

Levirate Marriage and Adoption99

Quotation from Frankel on Adoption100

The Tragedy of the Slums：Six Births in Seven Years101

Quotations from Federn-Meng102

Quotation from Havelock Ellis103

Quotation from Herschan104

FIRST INTERMEZZO OF APHORISMS105

PART Ⅱ THE ACHIEVEMENT OF DESIRED PREGNANCY109

CHAPTER Ⅳ．THE PHYSIOLOGY OF REPRODUCTION109

Necessary Normal Conditions110

Male Mechanism：Potentia coeundi111

Distillation or Lubrication111

Amount of Semen111

Motility of Spermatozoa112

Vitality of Spermatozoa113

Female Mechanism：Transport of Ovule114

Vitality of Ovule114

Ovulation：Provoked，Premature and Retarded115

Segmentation：Chromosomes118

Yolk or Chromatin119

Nidation or Implantation120

Corpus luteum121

Processes in Retarded Ovulation122

Coitus at any time in the Month can be Fertile122

Processes within the Ovule without Fertilization123

Development and Disintegration of the Unfertilized Ovule125

APPENDICES TO CHAPTER Ⅳ125

Chemical Affinities：Quotation from Kahn125

Motility and Vitality of Sperms within Female Organs127

The Transit of the Ovule：Unsolved Problems127

Oogenesis and Spermatogenesis128

Cell-conjugation and Fertilization130

Determining Influence of Living Ovule131

CHAPTER Ⅴ．THE GENERAL AND COITAL PROMOTION OF PREGNANCY135

Chief Factors135

General Habits of Life136

Mental and Occupational Injuries in Men136

Occupational Injuries in Women137

Special Susceptibility of Women137

Journeys：Travel and Fertility138

Psychic Interactions139

Love139

Diet：Underfeeding and Overfeeding140

Vitamines141

Condition of Genital Organs143

Prolonged Apathy and Excess143

Date in Monthly Cycle145

Importance of the Prelude145

Woman must be Wooed146

Actual Coital Technique：Mechanism of Fertilization147

Four Possibilities147

Importance of Simultaneous Orgasm149

Importance of Utmost Possible Penetration151

Position of the Feminine Organs151

A Tergo Position：Kneeling Attitudes152

Converse Position：Flexed Attitudes152

＂Normal＂Attitude153

Lateral Attitude from the Rear155

Genital Muscles：their significance in Woman159

The Constrictor cunni and Levator vaginae159

Training of the Perivaginal Muscles160

Experiments162

Possible Benefits164

Exercise and Control of all Human Faculties164

APPENDICES TO CHAPTER Ⅴ165

Vitamines and Hormones165

Ritual Infertility165

Notes on the Levator vaginae165

CHAPTER Ⅵ．STERILITY IN WOMEN167

PART Ⅰ SIGNIFICANCE，CAUSES AND MECHANISM167

Fundamental Significance of Motherhood167

Normal Women and Thwarted Motherhood167

What is Genuine Sterility？Three Years＇ Time Limit168

Temporary Postponement due to Maladjustment169

The Man＇s Responsibility：Direct and Indirect170

Primary and Secondary Sterility170

General，Functional，or Anatomical Causes171

Insufficient or Unsuitable Diet172

Climate173

Urban Life：Excessive Nerve Strain173

Alcohol，Nicotine and Drugs174

In-breeding174

Age175

Effects of certain Contraceptives175

Biochemical and Temperamental Incompatibility176

Psycho-sexual Factors177

Psychic Inhibitions178

Excessive Sensitiveness in the Genitalia179

Nymphomania181

Vaginismus181

Infantilism and Hypoplasia183

Inherited Tertiary Syphilis184

General Morbid Conditions184

Local Abnormalities184

Infections and Inflammations185

Importance of Gonorrhoea186

Injuries to the Ovaries187

Prevention is the Best Cure190

APPENDICES TO CHAPTER Ⅵ190

Reproductive Significance of Vitamine E190

Industrial and Occupational Injuries to Women＇s Organism190

Uterine Retroflexion as a Cause of Sterility191

The Term and Concept of＂Masturbation＂192

Simulated Pregnancy，Animal and Human192

Acquired Uterine Lesions193

Abortion and Sterility193

Ovarian Causes of Sterility193

CHAPTER Ⅶ．STERILITY IN WOMEN195

PART Ⅱ ITS PREVENTION AND TREATMENT195

Promptitude Essential in Prophylaxis195

Strict Cleanliness195

Effects of Overstrain195

Infantilism196

Excessive Prevalence of Arrested Genital Growth196

Medical Examination before Marriage196

Exchange of Certificates197

The Wedding Night and the Honeymoon198

First Pregnancy and Childbed198

A Miscarriage needs as much Care as a Full-time Delivery198

Sterility and Spermatic Saturation199

General Tonic Treatment200

Endocrine Therapy201

Rontgen and Radium Treatment201

Vibro Massage202

Treatment for Infantilism202

Uterine Pessaries203

Spermotaxis203

Local and Psychic Interactions204

Benefits of Iodine Treatment206

CHAPTER Ⅷ．STERILITY IN WOMEN207

PART Ⅲ TREATMENT BY SURGERY207

Dilatation of the Os uteri207

The Fructulet207

Curettage and Irrigations209

Accessory Surgical Measures210

Tubal Insufflation211

Tubal Operations212

Ovarian Operations213

Ovarian Transplantation214

Age at Possible Conception215

Prospects of Success in Prompt Treatment216

APPENDICES TO CHAPTERS Ⅶ AND Ⅷ217

Weak Dosages with Rontgen Rays217

Pessary Treatment of Retroflexion217

Insufflation of the Oviducts218

Salpingograms219

Pregnancies following Regrafts220

Successful Heteroplastic Ovarian Graft220

CHAPTER Ⅸ．IMPOTENCE IN MEN221

PART Ⅰ SIGNIFICANCE，MECHANISM AND PSYCHIC FACTORS221

Coital Impotence and Procreative Impotence221

Libido and Erection221

Ejaculation and Orgasm222

Absolute，Relative and Temporary Impotence223

Ejaculatio praecox225

Its Psychic Basis228

Impotence in Marriage229

Selectiveness of Sex Impulse in Men230

Impotence on the Wedding Night231

Neurotic Impotence232

Abnormalities of the Sexual Impulse233

Homo-sexuality：Innate and Acquired236

CHAPTER Ⅹ．IMPOTENCE IN MEN239

PART Ⅱ PHYSICAL CAUSES．TREATMENT239

General Morbid Causes239

Industrial Toxins240

Alcohol240

Nicotine240

General and Genital Tonics241

Endocrine Preparations241

Hydropathy244

Independent (Confidential) Reports from both Partners244

Psychotherapy244

Benefits and Dangers of Local Treatment244

Organic Defect245

Aspermatism and Its Cognates245

Chronic Alcoholism247

Gonorrhoea248

Pathological Changes in the Sperms249

Necrospermia250

Venereal Prophylaxis251

Sperms and Vaginal Secretions．Tests252

APPENDICES TO CHAPTERS Ⅸ AND Ⅹ253

Notes on Causation of Impotence253

The Tragedy of Impotence253

Momentary Impotence254

Bridegroom＇s Impotence254

Some Pharmaceutical Preparations255

Potency and its Disturbances (Marcuse)256

Restoration of Vasa deferentia (Fürbinger)256

CHAPTER Ⅺ．ARTIFICIAL FERTILIZATION，OR INSEMINATION258

Historical Outline258

Successes in this Method259

Indications and Contra-indications260

Dysgenic Considerations261

Technique261

Method of obtaining Seminal Fluid262

Suggestions as to Procedure263

Favourable Date in Monthly Cycle267

Religious and Ethical Objections268

Defence of Method268

APPENDICES TO CHAPTER Ⅺ269

Indications：Quotation from Nürnberger269

Quotation from Sellheim269

Quotation from Hirschfeld270

Papal Decree270

Quotation from Noldin271

SECOND INTERMEZZO OF APHORISMS272

PART Ⅲ THE PREVENTION OF UNDESIRED CONCEPTION277

CHAPTER Ⅻ．INTRODUCTORY．＂CONCEPTION＂AND＂PREGNANCY＂－＂ASEPSIS＂AGAINST SPERMS277

What is＂Undesired，＂and by whom277

Definitions of Conception and Pregnancy278

How and When does Pregnancy Begin279

The View of Catholic Dogma281

The View of Legal Experts282

From what Date do we Calculate Duration of Pregnancy283

Pregnancy begins with Implantation，not Fertilization283

Summary and Definitions285

The Basis of Contraception285

Asepsis and Antisepsis287

Aspermatic and Antispermatic Methods288

CHAPTER ⅩⅢ．THWARTING THE CONCEPTION BY SPECIAL TECHNIQUE OF SEXUAL INTERCOURSE290

Complete Abstention from Coitus290

Abstention from Coitus，but not from Contact and Caresses291

The Unsafe Period292

No Reliable Intermenstrual Dates292

Prolonged Lactation293

Suction without Lactation293

＂Karezza＂and Mazdaznan Coitus294

Coitus interruptus295

Its Wide Prevalence and Harmfulness295

Modern Modifications296

Coitus interruptus prolongatus296

Unadvisable as a Constant Habit298

Harmful Suppression of Orgasm in either Partner298

Crucial Points：Exact Region of Ejaculation？298

Angle or Direction of both Organs299

Contra-indications300

Urgent Warning against Violent Movements302

Danger of Vaginal Rupture303

Anatomical Contraceptive Technique304

Positions and Attitudes305

Converse Position：Normal Attitude．Attitude of Extension or Supination305

Attitudes of Flexion307

Attitude of Equitation307

Sedentary Attitude307

Anterior-lateral Attitude308

Note on Incompatibility of Flexion and Contraception308

Averse Position：Coitus a tergo308

Ventral Attitude of Woman308

Posterior Lateral Attitude309

Kneeling and Knee-elbow or Quadrupedal Attitude309

Active Expulsive Movements post-coitum310

Posterior Sedentary Attitude311

Comparison of Converse and Obverse Positions with Anatomical Contraceptive Technique313

APPENDICES TO CHAPTER ⅩⅢ314

Contraceptive Efficacy of Safe Period314

Damage of Coitus interruptus to Women (Kehrer)316

And to Men (Marcuse)317

Notes on Prolonged Coitus without Ejaculation317

＂Australian Movements＂318

CHAPTER ⅩⅣ．CONTRACEPTIVE APPLIANCES AND METHODS：MECHANICAL AND CHEMICAL319

There is no Ideal or Perfect Method of Contraception320

Essential to avoid Direct Ejaculation into the os uteri320

Mechanical Occlusion alone is not dependable321

Mechanical Methods：The Condom Sheath321

Technique of Coitus condomatus322

Advantages323

Defects323

The right to the Semen：＂Seminal Hunger＂325

A Second Line of Defence：Simultaneous use of Chemicals327

The Mensinga Pessary or＂Dutch Cap＂328

History and Description328

Medical Supervision in its Choice329

How long should the Mensinga remain in situ331

When should it be introduced332

Advantages and Defects of Occlusive Pessaries333

The Ramses and Matrisalus Pessaries334

Occlusive and Supporting Pessaries335

Cervical Caps or Portio Protectors in Rubber336

Comparison and Criticism of these Appliances337

Their Difficulties of Insertion and Adjustment339

Metal and Celluloid Cervical Caps340

Method of Application341

More Complex Patterns of Cervical Cap341

Chemical Methods should be combined with Caps341

How long should they remain in situ342

Safety Sponges343

Chemical Methods and Preparations343

Quinine344

Glycerine－Gelatine Fluids345

The Vaginal Suppository on a Cocoa-butter Base345

Its Defects and Insecurity345

Recipes for Chemical Contraceptives346

Gasogenous Tablets347

Contraceptive Jellies348

Method of Insertion351

Vaginal Douches352

Technique of Douching353

Intra-uterine Apparatus354

Obturators355

Dangers of all Intra-uterine Studs356

Silk and Silver Intra-uterine Rings357

Dangers of this Method358

Cauterization of the Uterine Lining359

Intra-uterine Procedure should be undertaken by Qualified Physicians alone362

APPENDICES TO CHAPTER ⅩⅣ362

Suggestions as to the Use of Occlusive Pessary362

The Use of the Rubber Cervical Cap363

Notes on the Efficacy of Certain Contraceptives (from Report of Breslau Gynaecological Society)364

CHAPTER ⅩⅤ．PERMANENT SURGICAL STERILIZATION366

Medical Indications366

Social and Eugenic Grounds367

Tubal Sterilization：Its History and Results368

Excision of the Pars interstitialis Uteri370

Other Modifications371

Criticism of Tubal Sterilization372

Operations on the Ovaries373

Operations on the Womb373

Surgical Sterilization of Men374

Indications375

Sterilization by Treatment of Uterine Mucosa375

Electro-coagulation376

The Tubal hystereoscope376

Advantages of this Method377

CHAPTER ⅩⅥ．TEMPORARY SURGICAL STERILIZATION378

Definition378

Indications378

Temporary Sterilization Preferable to Permanent379

Possible Modifications：Region and Procedure380

Van de Velde＇s Operation：Ovarian Encapsulation381

Littauer＇s Operation：Tubal Re-implantation382

Other Methods384

Criticism of Methods and Suggestions385

Reasons for preferring Ovarian to Tubal Operations387

Blumberg＇s Method388

Temporary Surgical Sterilization of Men389

The Mika Operation390

Reasons against this390

Synopsis of Matter on Surgical Sterilization392

CHAPTER ⅩⅦ．TEMPORARY STERILIZATION THROUGH BIOCHEMICAL METHODS394

Absorption of Spermatozoa394

Active Immunization against Spermatozoa394

Spermatolysins and Spermatotoxins395

Brief Duration of Immunity396

Passive Immunization397

Hormonic or Endocrinological Sterilization398

Haberlandt＇s Experiments399

Ovarialoptones and Placentaroptones401

Dangers of this Method401

Sterilization by Pancreatic Hormones403

The Male and Female Specific Sex Hormones (Steinach)403

Summary and Conclusion405

CHAPTER ⅩⅧ．STERILIZATION BY RADIOTHERAPHY406

Rontgen Castration and Rontgen Sterilization407

History of this Method407

Psychic and Physical Results409

Temporary Sterilization after Weak Dosage410

Its Duration410

Its Uncertainty and Dangers411

Injury to the Germ Plasm：before and after Conception411

Radium preferable to R6ntgen Rays414

Advantages and Disadvantages of Radium Treatment415

Rontgen Sterilization of Men417

CHAPTER ⅩⅨ．RECAPITULATION AND CONCLUSION．AUTHOR＇S VIEW OF THE PROBLEM OF ARTIFICIAL TERMINATION OF PREGNANCY＆Translated by C．A．Bang418

The Present and the Future419

Importance of Skilled Medical Advice419

The Duty of Medical Advisers：Should Pregnancy be Prevented，and，if so，how420

Panel Patients and Hospital Patients should be able to have this Advice422

University Schools of Medicine and Clinics must co-operate422

Systematic Enlightenment of：423

Married Couples423

Medical Profession423

Officials and Social Workers423

＂Ton Corps est à toi＂－The Author disputes this View424

The Unborn Child is a Living Human Being424

The Harmful or Fatal Results of Unskilled Interference426

Indications and Reasons for Legitimate Interference427

Termination of Pregnancy and Prevention of Conception429

The Lesser Evil to be preferred to the Greater430

APPENDIX TO CHAPTER ⅩⅨ430

Quotation from Lehmkuhl＇s Moral Theology430

EPILOGUE433

BIBLIOGRAPHY AND REFERENCES435