II.

Of the various appliances which have been devised for the prevention of conception, the simplest and most effectual is the “sheath” (commonly known as the “French Letter”). This an envelope of skin or very thin rubber, and is used by the husband. It completely covers the male organ, and, being closed at the extremity, prevents the semen from being discharged into the vagina. It is obvious that, if the sheath remain intact, it is impossible for conception to take place. The only danger to be guarded against is the breaking or perforation of the sheath, which should in all cases be carefully examined before use. The material may be tested by stretching it gently over the inside of the thumb, when the smallest fracture can be detected. If sheaths of good quality (not necessarily expensive) be used, and reasonable care taken to avoid accidental breakage, this check is CERTAIN.

The Enema Syringe is an instrument frequently employed for preventive purposes. A solution (composed of a teaspoonful of alum dissolved in a pint of cold or tepid water) is injected by the female immediately after connection. The vertical and reverse syringe is more likely to act efficiently than the ordinary enema.

A very simple and inexpensive method is the use of a small piece of fine sponge, soaked in warm water, and placed in such a position as to cover the mouth of the womb. The chances of failure are diminished by saturating the sponge with a solution of quinine.

Pessaries of various kinds are sometimes used to prevent conception. The simple pessary (of which there are several modifications) is a small dome-shaped appliance, made of thin rubber, and constructed to fit closely round the neck of the womb. If carefully adjusted and retained in position, the pessary may be relied upon.

Of late years a new form of pessary has been introduced and is stated to have been used with marked success. It consists of a small cone of cacao-butter, charged with quinine. The pessary is inserted a few minutes before connection takes place; the quinine, being liberated by the dissolution of the fatty substance, destroys the vitality of the seminal fluid.