,,conception ,,control ,,and ,,its ,,effects ,,on ,,the ,,individual ,,and ,,the ,,nation by ,,florence ,e4 ,,barrett1 ,c4,b4,e41 ,m4,d41 ,m4,s41 ,b4,sc4 ,consulting ,obstetric and ,gyncological ,surgeon to the ,royal ,free ,hospital4 ,president of the ,federation of ,medical ,women4 ,with a ,foreword by ,his ,grace the ,archbishop of ,canterbury4 #aibb ,,preface ,this small book has been written in response to many requests for some statement regarding the individual and national effects of the widespread practice of conception control4 ,it is not intended to give medical advice on the subject for1 in my judgment1 that is best given to the individual by his or her medical adviser1 and will vary in different circumstances4 ,the question as to whether control of conception shall or shall not be practised is a decision ethical and not medical in character when husband and wife are healthy1 and in the last resort will be decided by the individual pair for themselves2 but they will be wise to discuss the question with their medical attendant in order to realise all that is involved in their decision4 ,space forbids anything like a full discussion of the national issues1 but that aspect of the subject demands quite as careful study as personal needs or desires4 ,f4,e4,b4 #ca1 ,,devonshire ,,place1 ,w4#a4 ,september1 #aibb4 ,,foreword ,the ,archbishop of ,canterbury allows me to use the following letter as a ,foreword to this little book4 ,,dear ,,lady ,,barrett1 ,i have read with great interest the manuscript of your pamphlet4 ,very many of us who have daily to do with the problems and perplexities of our social life and to give counsel to the anxious or the penitent or the perturbed will thank you for these clear and cogent chapters4 ,to arguments based on moral and religious principle you add the weight of ripe experience and of technical scientific knowledge4 ,your words will gain access to the commonsense of many who would perhaps regard the opinions of clergy as likely to be prejudiced or uninformed4 ,i am of course not qualified to express an independent judgment upon the medical or physiological aspects of this delicate problem1 but ,i desire on moral and religious as well as on social and national grounds to support your general conclusions1 and to express the hope that your paper may have wide circulation among those who are giving attention to what is becoming an urgent question in thousands of ,english homes4 ,i am1 ,yours very truly1 ,,randall ,,cantuar4 ,,lambeth ,,palace1 ,s4,e4 #crd ,august1 #aibb4 ,,contents ,,chapter ,i ,,the ,,problem ,,of ,,to-,,day ,,chapter ,,ii ,,the ,,demand ,,for ,,knowledge ,,and ,,from ,,whom ,,to ,,obtain ,,it ,,chapter ,,iii ,,methods ,,chapter ,,iv ,,the ,,effect ,,of ,,widespread ,,conception ,,control ,,on ,,national ,,efficiency ,,summary ,,of ,,conclusions ,,chapter ,i ,,the ,,problem ,,of ,,to-,,day ,in the late seventies of last century a pamphlet entitled ,the ,fruits of ,philosophy was republished by ,mrs4 ,annie ,besant and ,mr4 ,charles ,bradlaugh1 in their desire to mitigate the suffering of poor women who were overburdened by work and further weakened by frequent child-bearing4 ,they resolved to face public obloquy and even legal prosecution in order to bring to these women knowledge of how to prevent conception1 which1 in their opinion1 would give the relief they so sorely needed4 ,as is well known1 the later pamphlet on the same subject written by themselves was withdrawn from publication by ,mrs4 ,besant in #ahhf on religious grounds4 ,during the last few years the idea of the need for conception control has again become prominent1 partly as a revolt against the bondage of women in child-bearing1 partly accentuated by the difficulties and uncertainties of an adequate livelihood1 and the desire to have a few children well educated and cared for rather than many who shift more or less for themselves4 ,but also the claim is made that marriage exists at least as much for the fulfilment of happiness in union with the beloved as for the procreation of children2 and that it should be possible for a married pair to have the fullest gratification without fear of children unless they desire them4 ,others1 but these are extremists1 go so far as to claim that apart altogether from marriage vows1 sexual intercourse should be the experience of all1 and that knowledge of how to avoid the birth of illegitimate children should be given to all4 ,the discussion of this subject has taken place under the title of ,birth ,control1 but the control or regulation of births is not really the point under discussion4 ,a very big factor in the diminution of births comes under the heading of abortions1 whether voluntary or through conditions which might be remedied4 ,that subject is not touched upon in this paper1 but only methods which avoid conception1 which is1 of course1 a very different subject from the larger one of avoiding births4 ,at first sight it might seem a comparatively simple thing1 in view of the knowledge which already exists of the physiological processes involved in conception1 to advise a method which shall prevent conception at will without harmful effect upon man or woman and yet leave intercourse unimpaired4 ,but even at first sight it is obvious that whatever knowledge may be available1 and whatever methods may be devised1 it would not be easy to convey this knowledge rightly to the individual it is hoped to benefit without doing harm to others4 ,further thought shows that the national problems involved are so important and far reaching in effects that they might well arrest the attention of the most careless advocate of indiscriminate conception control4 ,this is a subject1 therefore1 which requires careful consideration from the point of view of the individual1 of public morality1 and of national welfare--and the more closely it is studied the more apparent are the far reaching issues involved4 ,it is improbable that the practice of using contraceptives will continue for even a generation without revealing the harmful effects which must to some extent ensue4 ,in the whole discussion of this subject it is important to keep in mind that the physical is only one aspect of the sex relation4 ,in the evolution which sex has shared with all else1 the psychic side appears even in the higher animals4 ,in them the desire is not for mere indiscriminate physical satisfaction1 but the element of choice comes in1 a factor which sometimes upsets the plans of breeders4 ,in man this aspect of the relation is all important4 ,the higher side of sex1 or what we may call the psychical secondary sex characters1 seem to extend through the whole range of mental and spiritual activities4 ,because of this there is freshness of contact in mental and spiritual intercourse between men and women which differs somewhat from that between individuals of the same sex1 and very much of the joy of life springs from the impact of these differing yet completing selves the one upon the other4 ,where the whole being enters into the union of the sexes the complete joy of marriage is realised1 the characteristic of which is that it does not fade1 but becomes ever deeper and more fully realised1 a sure indication that the highest pleasure of sex union is only attained when it consummates a love which involves mutual sympathy and consideration4 ,physical union alone produces dissatisfaction the more quickly in proportion as it is physical only2 on the other hand1 when all parts of the nature find their counterpart in another1 the joy of such intercourse pervades the whole life1 and frequent repetition of physical intercourse is not essential to its highest development4 ,this is well known to all true lovers who have for varied reasons exercised some voluntary self-control in regard to the physical side of sex in marriage1 either in deference of the one to the desire of the other1 or to avoid too frequent child-bearing1 or in special seasons such as ,lent4 ,on the other hand it has been observed by most people that many marriages which seem to promise well1 quickly lose even to the eye of the outsider all the romance of the days of courtship4 ,is not too frequent physical indulgence sometimes the cause8 ,even the time of courtship is spoiled by unrestrained demonstration of affection1 and the beauty of the higher side of love is apt to lose its delicate bloom by over accentuation of the physical in marriage2 husband and wife sadly admit to themselves that disillusionment has come--the real truth being that in seeking only physical satisfaction in each other1 their eyes have become blinded to those higher qualities which each glimpsed in the other during the happier days of courtship1 and the road of the loving hearts1 which they hoped to tread through life1 has been missed because they have forgotten that man is a spirit and doth not live by bread alone4 ,to many the introduction of this aspect of the question may seem beside the mark4 ,for them the practical question in a world of sense is how to avoid having children when for any reason they are not wanted1 and yet leave unimpaired facilities for married life4 ,it is true the problem is not always stated so bluntly4 ,the uses of contraceptives are explained1 together with a recommendation for moderation in physical intercourse2 but as will be shewn below1 if such moderation is really practised1 it is possible to live a natural married life such as renders unnecessary the use of artificial contraceptives with all their attendant evils and yet limit the size of the family4 ,but it is necessary to consider more carefully the claim made to-day that contraceptives are both necessary and harmless1 and that public propaganda on the subject is desirable4 ,there are several different groups for whom relief is claimed3-- #a4 ,women who are suffering from chronic or from temporary ill-health are frequently not in a condition to bear the strain of child-bearing1 and indeed it may become a real danger to their future health1 either mental or physical4 #b4 ,there are cases of inherited disease1 mental or physical1 which ought to prohibit child-bearing4 #c4 ,there are over-worked women whose daily work1 added to child-bearing1 destroys their health and vitality4 ,these people are found not only among the so-called working classes2 the same conditions with somewhat different types of strain are found in wives of professional men with very slender incomes4 #d4 ,some parents wish to space their children1 that greater attention may be given to each1 or they wish to limit the number of their family on account of financial and other difficulties4 ,with these and other considerations in view1 the widespread teaching of methods of preventing conception is advocated because it is claimed3-- 7a7 ,that except for general propaganda1 the greatest sufferers1 viz41 poor women with constantly recurring pregnancies1 would otherwise never learn of any method of relief4 7b7 ,that many young people who for various reasons1 such as housing or financial difficulties or inherited disease1 feel themselves unable to have a family1 would if such knowledge were available marry much earlier1 and their natural desires would be satisfied1 while apart from marriage they might resort to promiscuous intercourse4 7c7 ,that homes where the growing difficulties and strain of a continually increasing family are leading to estrangement between husband and wife1 are restored to happiness when saved from the difficult choice between continence1 which they have never trained themselves to practice1 or many children with which they cannot cope4 ,there are1 however1 serious fallacies in these contentions4 ,the propagandists of conception control appear to take it for granted that after preventive measures in early youth1 children may be conceived at will whenever they are desired2 and1 moreover1 it is assumed that apart from such precautions every woman will conceive annually and will continue to do so until #aj-ab children have been born4 ,neither of these suppositions is supported by facts4 ,on the contrary1 there are large numbers of married couples who would give anything to have children1 but have postponed it until circumstances should seem quite desirable1 and then1 to their grief1 no children are given to them4 ,it is very unfair to teach people that they may safely postpone the natural tendency to bear children in youth and rely upon having them later in life4 ,probably gyncologists are consulted more often by women who desire children but do not have them1 than by those who wish to avoid having them--the truth being that the tendency among people in comfortable surroundings is towards relative sterility rather than towards excessive fertility4 ,those who are interested in this aspect of the question will find the facts admirably set forth in ,mr4 ,pell's book on ,the ,law of ,births and ,deaths1 being a study of the variation in the degree of animal fertility under the influence of environment4 ,he finds that the all-important factor which determines fertility is the amount of nervous energy of the organism1 and that nervous energy is produced or modified by three specially influential factors1 viz41 ,food1 both quantity and quality2 ,climate1 hot or cold--moist or dry2 and1 lastly1 all those varied conditions which make for greater or lesser mental and physical activity4 ,fertility1 broadly speaking1 varies in inverse proportion to the degree of nervous energy or what we may call vitality4 ,conditions1 therefore1 which lower the general vitality below the normal produce abnormal fertility4 ,this excessive child-bearing under present conditions still further lowers the standard of life and the health of the mother1 hence a vicious circle is set up1 the only escape from which will come by such consideration of the laws of health relating to work1 housing1 food and recreation as shall ensure the maximum of vitality to the workers4 ,this is the true method of conception control4 ,there comes a point in the development of nervous energy which is productive of sterility4 ,it is true that principles based on so many varying factors will necessarily appear to fail in individual cases4 ,environment with its influence on the nervous energy of the individual will be modified by the inherited tendency of that individual towards fertility or the reverse4 ,we find1 therefore1 isolated cases of large families among the well-to-do and small families among those whose vitality is below the normal1 but if the general principle is true we should expect to find a larger number of sterile marriages among the well-to-do than among those whose lives are more full of hardship1 and this undoubtedly is the case4 ,this aspect of the problem is deserving of careful study4 ,the desire for children in so many homes where every advantage could be given1 may be gratified when more knowledge of how wisely to modify the environment of the rich is within our grasp4 ,it may be that the more simple life among those who have much will give to them the prize of children which they covet more than things which wealth can buy4 ,but let us return for a moment to the false expectation that children will come to all unless prevented4 ,the results of this assumption are really serious4 ,they involve the training of large numbers of people in unnatural practices1 which in many cases are unnecessary1 even if they were desirable4 ,they rob many families of the children who would have been the delight of their parents through middle and later life4 ,moreover1 it is obvious that advice which may be quite necessary in cases of ill-health or special conditions1 may be fundamentally wrong to give broadcast to all individuals1 for apart from the fact that when given to all it is largely unnecessary1 there are other serious objections1 as follows3-- #a4 ,a public opinion at the present time is being gradually produced which takes it for granted that as a matter of good form young people should not have children for a few years after marriage1 and it is becoming a common practice to start married life with sordid and unnatural preparations for a natural act2 yet many of these young people1 men and women alike1 are most anxious to have children1 and only seek to know how to prevent them because they believe it to be the thing to do4 ,one or two illustrations which have come to my personal knowledge will perhaps show the kind of idea which is conveyed to the mind of young people by books and speeches on this subject1 though such results may not have been desired by the authors or speakers4 ,a young bride came to her mother on returning from her honeymoon and said1 ,mother1 how long must we wait before having children--is it really necessary to prevent them for a year or two8 ,we are both dying to have babies4 ,a young couple on the eve of marriage consulted a gyncologist regarding the question of using the cap pessary to prevent the possibility of having children for a few years4 ,the bride1 who was greatly distressed1 produced the pessary which she had purchased1 and said she could not possibly use it2 her fianc1 however1 had been advised that she could1 and ought to do so1 hence the first serious dispute had arisen between them1 clouding the future4 ,she was told by her doctor that it was quite impossible for her1 and this fully satisfied the future husband4 ,the next point was if this method were impossible what should be used4 ,they were a splendid young couple1 with ample means to support a family1 and the doctor naturally asked--,but for what purpose do you need any methods to prevent children at all8 ,they hesitated and looked at each other1 and then said--,i don't know1 but we thought it was the thing to do4 ,they left with the whole nightmare put aside1 determined not to spoil the perfect consummation of their happiness4 ,many similar cases might be quoted where young people1 without any considered motive1 are acting in accordance with the vogue of the moment4 #b4 ,the use of contraceptives does not encourage self-control1 yet the cultivation of self-control is a far higher gain to the individual and the nation than any apparent advantages obtained by its abandonment4 ,by no means unimportant is the influence that wide diffusion of the knowledge of how to prevent conception would have in causing more irregular unions and greater promiscuity in sex relations4 ,the effect of this would not only loosen1 rather than strengthen1 the marriage tie1 but would inevitably lead to an extension of venereal disease4 ,many people seem to think that contraceptives prevent venereal disease at the same time that they prevent conception4 ,but this is not so4 ,the use of methods of prevention by women is no protection to them from infection4 #c4 ,we have1 moreover1 to take a wider view1 and consider who will receive and act upon the advice given1 and hence what the result will be on the differential birth-rate of the community4 ,it is quite obvious that the educated classes can most easily follow instructions which result in protection from conception1 and since such knowledge most easily circulates among the more highly endowed classes1 it has been claimed that it is important to make efforts to let the knowledge be so widespread that it may reach all4 ,the result1 however1 could only be that the practice of conception control would spread throughout the upper1 middle and more intelligent of the working classes1 and this would involve a very serious reduction in the births of those who furnish the leaders and efficient workers in all branches of life1 and in those only4 ,for the birth-rate amongst the least intelligent1 least efficient and the mentally deficient will be unaffected4 ,it must be apparent that after a very few generations of such weeding out of the best1 with the continuous multiplication of the worst type of citizen1 the general standard of efficiency1 enterprise and executive skill of the nation would be seriously impaired4 ,such1 briefly stated1 is the problem before the public at the present time4 ,,chapter ,,ii ,,the ,,demand ,,for ,,knowledge ,,and ,,from ,,whom ,,to ,,obtain ,,it ,even the brief survey given in the first chapter will have suggested to the reader that the people who ask for knowledge seek it for various reasons4 ,indeed1 the first thing that strikes anyone who gives consideration to the subject is the difference in type and circumstance of the people for whom relief is claimed4 ,we begin to realise at once that the subject of conception control is an intimate and individual one1 and can only really be dealt with by advice which is given to the individual and not to the public at large4 ,this is perhaps most obvious in the first group mentioned on page #ag1 where the woman is suffering from chronic or acute disease1 and the necessity for preventing conception is clear to her medical adviser4 ,if disease renders child-bearing a danger to the life and health of the mother1 it becomes a positive duty of her doctor to prevent such a catastrophe--but the method advised will differ according to the special nature of the case4 ,again1 where in the case of husband or wife there is a serious inheritance of mental or physical disease1 and especially when the same weakness exists in both families1 it is justly regarded as a duty by the married pair not to bring children into the world4 ,it may be contended that men and women with such an inheritance should not marry1 but that is a matter for the decision of the individuals concerned4 ,it not infrequently happens that marriage has taken place before they know of the inherited tendency4 ,in such cases clearly the advice of the family doctor should be given as to the best course to pursue in order to avoid conception4 ,the case of the overworked and burdened mother with a large and increasing family is nearly allied to that of a woman with disease1 though in her case the causes for ill-health are more complicated4 ,while it is true that ill-health and premature ageing in working women are the result of many causes1 yet where child-bearing still further injures health it is essential that she should consult her medical adviser on this point1 for she not only needs treatment to restore her health1 but also advice specially suitable to her own case1 as to the best method to avoid conception for the time being1 and such advice will vary according as the disability is temporary or permanent4 ,it is1 happily1 as possible for the poor woman to obtain advice in all matters of health as it is for the rich4 ,the mothers of the country are in touch everywhere with maternity clinics1 where doctors advise them on all questions of health relating to pregnancy1 and treat each woman as a separate individual4 ,but the case of the poor working woman overburdened with work which she cannot accomplish--yet with the added burden of bearing more children than her more fortunate sisters1 deserves some further consideration4 ,what is it that prematurely ages so many of these women of the slums--is it child-bearing alone8 ,the answer to that is immediately in the negative1 for women in comfortable circumstances may have large families1 with no sign of weariness and dejection4 ,no1 the causes of ill-health and debility are diverse1 and to pretend to solve the question by conception control is a mockery1 for it salves the conscience of the community without really dealing with the question of the disabilities of the working woman1 or the true cause of her excessive fertility4 ,ill-health in working-class mothers often has its origin in inherited weakness and lack of care in childhood4 ,it is further accentuated by overwork1 with no labour-saving devices2 lack of suitable food2 too few1 if any1 hours of recreation1 and hence very little out-door exercise4 ,badly ventilated homes deprive the mother of necessary supplies of oxygen1 and insufficient sleep is often the last straw which breaks down the patient burden bearer4 ,a true and haunting picture is given in a recently published book called ,the ,woman in the ,little ,house 7which first appeared in a series of articles in the journal ,time and ,tide71 describing the anxiety of a working woman at night to keep her baby quiet that the husband may sleep4 ,now it is quite true that a small family instead of a large one will diminish the work and anxieties of such a mother1 but it will not give her the remedies which she needs1 nor will it diminish the excessive sexual demands made upon her4 ,everyone who knows these women intimately realises what an exhausting feature is this habit of excess due to lack of knowledge or self-restraint on the part of the husband4 ,i believe if facilities were provided whereby the woman could do her laundry with modern appliances outside her own home1 if family meals were arranged in service rooms equivalent to the arrangements in service flats1 and if there were crche rooms where children might be left for an hour or two in safety while necessary work was done--we should find a greatly increased standard of comfort even in existing homes1 and a great improvement in dietary for the whole family4 ,such relief1 added to teaching both to husband and wife as to the times of conception1 would revolutionise the life of women more than any teaching of artificial birth control1 and would lift it up to a higher level instead of degrading it to the grossly physical4 ,we come to very different considerations in group #d1 p4 #ah1 where choice rather than necessity impels the parents to limitation of the family4 ,the teaching now being advocated by certain books and pamphlets advises deliberate delay in child-bearing for a period after marriage1 and the spacing of certain periods between the births of such children as are allowed to come into the world1 with limitation of the number in each family4 ,teaching on these lines1 if followed1 would involve an artificial mode of sex life always--natural spontaneous union would find no place4 ,already young wives are seeking advice for some relief from methods of preparation which they say have destroyed in them all spontaneous desire4 ,the tragedy of it all is that even to attain the end in view--moderation in the size of families--such methods are to a large extent unnecessary4 ,not to every young married couple does a child arrive at the end of a year4 ,some1 using no artificial checks1 wait two or three years before the first baby comes4 ,even if it does come1 however1 at the end of a year1 there are many advantages to counterbalance the small means and perhaps hard living of the young pair4 ,for when people are young they can put up with small means1 because they are strong enough to work hard and help each other2 indeed1 the demand for little work and many luxuries in youth is not a healthy one1 it is a sign of decadence in the race4 ,moreover1 even though an early family involve real hardship for awhile1 it has the great advantage that parents and children later on are still young together1 and that means far more to the child in understanding friendship and helpfulness during the most critical period of life than extra comforts or pleasures would have meant to the parents1 and if young parents realised this1 would they not put the child first8 ,the so-called advantages of a few years between one child and the next so that the parents may give fuller care and attention to each1 are far outweighed from the child's point of view by the advantages of playmates in the nursery of nearly its own age1 who are a source of education in the give and take of life such as no adult can supply4 ,if parents wish to have only three or four children1 it is to the advantage of the mother as well as of the children1 to have the little family early in life--they are then all in the nursery together1 and later all at school1 and her life work is in this way so arranged that she may give most service to the world in addition to carrying on the race4 ,our conclusion is that for mothers and children it is very desirable that no contraceptives should be used in the early years of married life4 ,in the vast majority of families where no restrictions or unnatural means are used and where mothers nurse their children for eight or nine months1 children only come every two years4 ,even if a young couple decide that they cannot afford to bring up more than four children1 they have first to prove that four children will be given them--in many cases they will not have so many1 and as years go by the fertility of the mother becomes progressively less1 so that if child-bearing is postponed till after thirty1 in a certain number of families no children are born4 ,there are many men and women who bitterly regret having let the years go by in which children might have been born to them1 and it is only fair that young couples of to-day should fully understand this risk4 ,,chapter ,,iii ,,methods ,there are certain points in regard to methods of preventing conception which should be made clear4 ,it is1 of course1 obvious that conception can be voluntarily controlled by abstention from intercourse except when children are desired4 ,this has been called a counsel of perfection4 ,it could only rightly be so described where such a method of life was both desired and approved by both husband and wife4 ,it would not be a fair thing for either to enforce a practically celibate life on the other without the fullest understanding and consent before the marriage vows were taken4 ,but conception can also be controlled by avoidance of those parts of the monthly cycle in which conception most commonly takes place4 ,that in the great majority of women there is a time in the monthly cycle when no conception occurs has been noted for a long time4 ,the rough-and-ready method of reckoning the date of birth in relations to the last menstrual period is an example of the assumption that conception will probably have taken place a week later1 and the frequency with which such reckoning is justified shows that it is not altogether unfounded4 ,during the war it was possible to make some more exact observations owing to the short leave granted to soldiers to visit their homes4 ,seigel has published a paper in the ,mnchener ,medizinische ,wochenschrift1 #aiaf1 in which he gives information regarding the conception of between two and three hundred children born during the war4 ,he finds that the likelihood of fertilisation increases from the first day of menstruation1 reaching the highest point six days later1 the fertile period remains almost at the same height till the #abth or #acth day1 and then declines gradually until the #bbnd day1 after which there is absolute sterility4 ,this suggests that conception control can be attained without artificial methods if intercourse is confined to one week in the month4 ,such control of conception1 though natural1 does not make it any more desirable to space the births unduly so that the children are brought up in separate units instead of in a happy family group in which they can share games and interests--but it does avoid the risks which are associated with artificial methods of conception control4 ,it is not proposed to discuss in detail artificial methods in this pamphlet1 because no advice can be wisely given on this subject in a general way4 ,those who after careful consideration choose to use artificial means to prevent child-bearing will be wise if they consult their medical attendant as to those methods which are least harmful for their individual case1 and ask for careful instruction in their use4 ,most of the methods so widely advertised are productive of diseased conditions1 whether from the nature of the method itself or from the way in which it is used1 and all of those recommended to women interfere with normal physiological processes4 ,the object aimed at in methods recommended to women1 is either to produce1 by drugs or otherwise1 conditions in the vagina inimical to the life of the male cell1 or to prevent by mechanical means the reception of the semen into the uterus4 ,owing to the uncertainty in the results of either of the above methods of prevention1 the later editions of books which teach conception control now advocate the use of both methods at the same time in order to approximate more closely to certainty of result4 ,all these artificial preparations for intercourse demand from the woman an investigation of and interference with her own internal organs1 which is revolting to all decent women1 and such teaching is directly opposed to the advocacy of cleanliness and non-interference with the genital organs1 which is the natural habit of healthy-minded women4 ,the effects1 however1 go further than this4 ,nature has provided in the healthy vaginal secretions an antidote to infection which quickly destroys harmful germs4 ,if the natural secretions are altered it is difficult to restore them to their natural quality4 ,professor ,arthur ,thomson1 ,f4,r4,c4,s41 has shewn 7,british ,medical ,journal1 ,january #gth1 #aibb7 from observations of the lining of the womb in animals and in women that the weight of evidence goes to prove that its function is more likely to be absorbent than excretive1 and that as such it plays an important part in the animal economy4 ,after describing at length the evidence that the male secretion consists largely of the secretions from special glands as well as the sex cells1 he refers to the fact that these are all largely received into and absorbed by the glands of the womb1 and he discusses the probability that such absorption profoundly and beneficially affects the physiological reaction in the woman4 ,he points out that the use of artificial checks while preventing fertilisation may also be the means of depriving the female of certain secretions which may exercise a far reaching influence on her economy2 and he concludes1 ,as a rule we cannot interfere with the normal course of nature without some consequent evil result4 ,may this not be an instance in which for some apparent gain in one direction1 the woman pays the penalty8 ,,chapter ,,iv ,,the ,,effect ,,of ,,widespread ,,conception ,,control ,,on ,,national ,,efficiency ,in every nation individual capacity varies within wide limits4 ,we have men and women of brilliant attainments1 and of all grades of intelligence ranging downwards to the mentally defective4 ,there is no doubt that all grades of intelligence can be improved by education1 but there appears to be a limit to the capacity of development of each individual4 ,lower intelligence1 therefore1 is not only due to lack of opportunity1 but to an inborn constitutional defect4 ,further study has shewn this defect to be hereditary--the parents or grandparents of such people shew defective intelligence1 and their offspring are likely to do the same2 indeed1 if two mentally defective people marry it is fairly certain that their children will all be mentally defective4 ,there are1 however1 no sharply defined classes of intelligence2 just as the mentally defective are in many grades1 so ordinary men and women vary from low or average intelligence up to outstanding cases of genius or capacity4 ,by the newer methods of mental testing it has been shewn that children of various classes of the community1 as well as men and women of different races1 can be grouped according to their intellectual capacity1 and that no educational facilities will develop that capacity beyond a certain point4 ,professor ,w4 ,mc,dougall1 ,f4,r4,s41 in his most useful and interesting book on ,national ,welfare and ,national ,decay1 reaches the important conclusion that innate capacity for intellectual growth is the predominant factor in determining the distribution of intelligence in adults1 and that the amount and kind of education is a factor of subordinate importance4 ,he claims that the evidence is overwhelming as to the validity of the results obtained by mental testing4 ,a few examples of experimental work given in ,professor ,mc,dougall's book will suffice to show the trend of these results4 ,tests of intelligence were carried out on recruits for the ,american ,army1 white and coloured1 and they shewed marked superiority of the white race4 ,a special test was carried out in ,oxford by ,mr4 ,h4,b4 ,english1 who compared the capacity of boys in a school attended by children of the intellectual classes with that of boys in a very good primary school1 whose fathers were shop-keepers1 skilled artisans1 etc41 coming from homes which were good1 with no sort of privation4 ,the result showed marked superiority of the sons of intellectual parents4 ,mr4 ,english concludes that the children of the professional classes1 between #ab and #ad years of age1 exhibit very marked intelligence1 and he is convinced that the hereditary factor plays an altogether predominant part4 ,in another experiment1 ,miss ,arlitt1 of ,bryn ,mawr ,college1 tested #cdb children from primary schools in one district1 who were divided into four groups3-- ,group #a4 ,professional4 ,group #b4 ,semi-professional and higher business4 ,group #c4 ,skilled labour4 ,group #d4 ,semi-and unskilled labour4 ,marked differences between the groups were shewn4 ,the intellectual capacity was represented by figures as follows3-- ,group #a #abe ,group #b #aah ,group #c #ajg ,group #d #ib ,a further research of #edh children1 grouped according to the occupation of their father1 gave its results in terms of the percentage of children in each group who scored a mark higher than the median for the whole #edh4 ,they are as follows3-- ,professional group #he ,executive group #fh ,artisan group #da ,labour group #ci ,in the ,journal of ,educational ,psychology1 ,vol4 ,,ix1 #aiaf1 ,mr4 ,a4,w4 ,kornhauser gives evidence from the examination of #a1jjj children drawn from five schools in ,pittsburgh4 ,schools ,a and ,b were attended by children of unskilled manual workers4 ,schools ,c and ,d by children of skilled artisans and small shopkeepers4 ,school ,e by children of parents in very comfortable circumstances4 ,the results are tabulated as-- ,retarded1 i4e41 below average4 ,normal1 i4e41 average4 ,advanced1 i4e41 above average4 ,retarded4 ,normal4 ,advanced4 ,a ,manual workers #de4b #dg4a #g4g ,b #cf4g #ee4i #g4d ,c ,artisans1 etc4 #bi4d #ej4b #bj4g ,d #bh4h #ej4b #ai4e ,e ,most comfortable #ab4g #fb4g #bd4f;,a ,footnote ,a3 ,i am indebted to ,professor ,mc,dougall's book for information here given4 ,these experiments all shew the trend of intelligence 7and with it will power or power of concentration1 and what we may call general capacity7 to be more concentrated in the so-called higher grades of society1 and to be less and less evident as we descend in the scale from skilled to unskilled workers4 ,it would1 of course1 be clear to all that the children of mentally deficient parents can only be a burden on the ,state or can rarely contribute anything of value to the common weal4 ,now the teaching and advocacy of methods of conception control is most easily assimilated and practised by the intelligent classes2 indeed1 we may say with certainty that such methods can only be used effectively by the intelligent members of the community1 such as leisured1 professional and mercantile classes1 skilled artisans and better class workers1 whereas the lowest type of casual labourers whose home conditions render the use of preventive methods difficult or impossible1 and the mentally deficient and criminal classes1 are unaffected by such teaching4 ,the result in a few generations must be a marked decrease in the numbers of the intellectual and efficient workers1 while the hopelessly unfit continue to produce their kind at the same rate as before4 ,the figures given do not suggest that individuals with marked ability are to be found in the upper classes only1 but they do indicate that there is a larger proportion of boys and girls in the more comfortable classes whose inherited ability is above the average1 though this may be partly due to the more intellectual atmosphere in which their early childhood has been passed4 ,the provision of education for all1 with facilities for children of every class to pass on to higher grades of work1 is essential if the latent powers in all1 whatever they may be1 are to be developed to the utmost4 ,the point for our consideration at the moment1 however1 is that if the production of all capable workers1 whether mental or manual1 is to be curtailed and the numbers of the population maintained in greater proportion from the mentally deficient or criminal classes1 the result must be national disaster4 ,for in a very short time there will not be enough leaders of real capacity to occupy positions of initiative and responsibility in the various activities of the country at home and abroad1 nor will there be an adequate supply of good practical work3 a lowered standard of efficiency must result4 ,from a national point of view1 therefore1 we regard the propaganda in favour of conception control to be a real and increasing danger4 ,the problem of the mentally deficient is of another order4 ,in this case another kind of control is urgently needed1 but it is one which can only be undertaken by the ,state1 and not by the individual4 ,it is to put in force such a method of compulsory segregation as would ensure the comfort and contentment of the mentally deficient1 and safeguard them and the nation from the reproduction of their kind4 ,the problem also of the insane and criminal classes in relation to heredity is one which demands careful consideration by those competent to give it4 ,,summary ,,of ,,conclusions #a4 ,there are certain women who for medical reasons should be prevented from bearing children4 #b4 ,there are couples with undesirable inheritance who rightly decline to bear children4 #c4 ,there are many women of the poorer classes in whom child-bearing is sometimes the last straw in circumstances all of which tend to destroy health and vitality4 #d4 ,public teaching on contraceptives1 like medical advice advertised in newspapers1 is generally applied to cases for which it is unsuitable and applied in the wrong way4 ,it is therefore detrimental to public health as well as being detrimental to public morality4 #e4 ,a public opinion in favour of small spaced families does not serve the best interests of the children or of their mother4 #f4 ,married love should express itself at once in the usual way without the use of artificial contraceptives4 #g4 ,the diminishing fertility of the more capable classes is a national peril4 ,to counteract this tendency every encouragement should be given to the intelligent and efficient classes of the community to bear healthy children4 ,the study of problems which give rise periodically to a propaganda in favour of the practice of conception control reveal the fact that excessive child-bearing is found in those classes who suffer the greatest privation1 and in whom large families are a real hardship1 while many couples among the well-to-do are childless though greatly desiring children4 ,such facts suggest that the true remedy for the general problem lies in raising the standard of living among working-class mothers and advising a more simple life to the more richly endowed4 #h4 ,it is desirable that the ,government should make provision for methods which will arrest the propagation of the mentally deficient1 insane and criminal classes4