PART Ⅰ ETHICAL POSTULATES AND PRINCIPLES 1
CHAPTER Ⅰ．INTRODUCTION．THE ETHICAL AND THEOLOGICAL ASPECTS．THE STANDPOINT OF THIS STUDY 1
Difficulties of the Subject 1
Three Groups of probable Readers 2
Illusion 4
Fiction 5
Vital Hypothesis 5
Significance of Religion：Ethical and Practical 6
Sexual Abstinence if effective must be absolute 9
Sexual Starvation 10
Condemnation of Prolonged Abstinence within Marriage 10
The Large Families of the Past 11
Regulation of Reproduction need not be Extreme 12
Three to Four Children at intervals of two and a half Years 13
Children should be Born before the Mother is thirty-five 13
The Roman Catholic Church：Dogma and Codes 14
＂Facultative Sterility＂：Capellmann-Bergmann 15
Seasonal Diminution of Probable Conceptions 16
Noldin 17
Gury-Ballerini 18
Tempus ageneseos (＂Safe Period＂) 18
＂Abruptio Copulae＂before Emission 20
Contradictions among Catholic Moral Theologians 21
Exodus from the Churches 23
Letter of the Bishop of Le Mans 24
Attitude of Protestant Theologians 28
Wichern 28
Knabe 30
Weymann 31
Failure of Church Guidance to their Flocks 33
The Medical Profession has the Duty to Advise 35
APPENDICES TO CHAPTER Ⅰ 35
Noldin，Original Text 35
Noldin，Telch，Gury-Ballerini Original Texts 36
Monseigneur Bouvier，Original Text 39
The＂Sin of Onan＂ 42
Quotation from Kirstein 44
Quotation from Haug 45
Copec 46
The Hebrew Faith and Contraception 47
The Lambeth Conference 47
Quotation from Wichern 48
CHAPTER Ⅱ．FAMILY LIMITATION IN ITS NATIONAL，INTERNATIONAL AND RACIAL ASPECTS 49
Grotjahn 49
The Egotism of the Sexual Impulse 49
Harmony of Interests：Individual and Communal 50
Difficulties of the Population Problem 51
Dangers of Unbalance，Ethnic and Cultural 52
Neither Overpopulation nor Depopulation 53
The Situation in Contemporary France 55
Difficulties of Assimilation 55
Dangers to Cultural Level 57
Make it advantageous to have Children! 59
Position in Western and Central Europe 61
Grotjahn＇s View：Minimum of Three Children 63
Financial Privileges for Large Healthy Families 65
The Housing Problem 67
Large-Scale Measures advisable 67
Quantity and Quality 67
Diminished Numbers affect Quality 67
Each Social Stratum should make good its Losses 68
Improvement of Quality Imperative 68
Wholesome Happy Sex Lives and Births benefit the State 68
Summary of Economic Arguments 68
APPENDICES TO CHAPTER Ⅱ 68
Quotation from Labat 68
Quotation from Harmsen 69
Quotation from Le Fêvre 70
Quotation from Lagneau 72
The Number of Children 73
The Housing Problem 75
Extinction of Intellectual Classes 76
Increase of Valuable Racial Elements 77
CHAPTER Ⅲ．THE INDIVIDUAL ASPECT OF FERTILITY AND STERILITY IN MARRIAGE 79
The Third Corner-Stone of Married Happiness 79
Differences between Men and Women in Parental Urge 80
The two Groups of Childless Wives 80
What Children mean to Men 81
Rational or Intellectualized Parenthood 83
A Vital Question 84
The only Child：Difficulties and Handicaps 85
The Best Number：Three or Four 87
The only Practicable Method is Contraception 88
Unavoidable Disadvantages 89
Loss of Complete Spontaneity 89
AEsthetic Factors 90
Warning against Frivolous and Hasty Decisions 91
Psychic Disturbances and Conflicts 93
Injury to Specific Erotic Pleasure 94
A Serious Matter：to be Settled seriously 96
Reverence for Life 96
Sense of Responsibility and Duty of Steadfastness 97
APPENDICES TO CHAPTER Ⅲ 98
Quotation from Reich 98
Economies of Parenthood 98
Levirate Marriage and Adoption 99
Quotation from Frankel on Adoption 100
The Tragedy of the Slums：Six Births in Seven Years 101
Quotations from Federn-Meng 102
Quotation from Havelock Ellis 103
Quotation from Herschan 104
FIRST INTERMEZZO OF APHORISMS 105
PART Ⅱ THE ACHIEVEMENT OF DESIRED PREGNANCY 109
CHAPTER Ⅳ．THE PHYSIOLOGY OF REPRODUCTION 109
Necessary Normal Conditions 110
Male Mechanism：Potentia coeundi 111
Distillation or Lubrication 111
Amount of Semen 111
Motility of Spermatozoa 112
Vitality of Spermatozoa 113
Female Mechanism：Transport of Ovule 114
Vitality of Ovule 114
Ovulation：Provoked，Premature and Retarded 115
Segmentation：Chromosomes 118
Yolk or Chromatin 119
Nidation or Implantation 120
Corpus luteum 121
Processes in Retarded Ovulation 122
Coitus at any time in the Month can be Fertile 122
Processes within the Ovule without Fertilization 123
Development and Disintegration of the Unfertilized Ovule 125
APPENDICES TO CHAPTER Ⅳ 125
Chemical Affinities：Quotation from Kahn 125
Motility and Vitality of Sperms within Female Organs 127
The Transit of the Ovule：Unsolved Problems 127
Oogenesis and Spermatogenesis 128
Cell-conjugation and Fertilization 130
Determining Influence of Living Ovule 131
CHAPTER Ⅴ．THE GENERAL AND COITAL PROMOTION OF PREGNANCY 135
Chief Factors 135
General Habits of Life 136
Mental and Occupational Injuries in Men 136
Occupational Injuries in Women 137
Special Susceptibility of Women 137
Journeys：Travel and Fertility 138
Psychic Interactions 139
Love 139
Diet：Underfeeding and Overfeeding 140
Vitamines 141
Condition of Genital Organs 143
Prolonged Apathy and Excess 143
Date in Monthly Cycle 145
Importance of the Prelude 145
Woman must be Wooed 146
Actual Coital Technique：Mechanism of Fertilization 147
Four Possibilities 147
Importance of Simultaneous Orgasm 149
Importance of Utmost Possible Penetration 151
Position of the Feminine Organs 151
A Tergo Position：Kneeling Attitudes 152
Converse Position：Flexed Attitudes 152
＂Normal＂Attitude 153
Lateral Attitude from the Rear 155
Genital Muscles：their significance in Woman 159
The Constrictor cunni and Levator vaginae 159
Training of the Perivaginal Muscles 160
Experiments 162
Possible Benefits 164
Exercise and Control of all Human Faculties 164
APPENDICES TO CHAPTER Ⅴ 165
Vitamines and Hormones 165
Ritual Infertility 165
Notes on the Levator vaginae 165
CHAPTER Ⅵ．STERILITY IN WOMEN 167
PART Ⅰ SIGNIFICANCE，CAUSES AND MECHANISM 167
Fundamental Significance of Motherhood 167
Normal Women and Thwarted Motherhood 167
What is Genuine Sterility？Three Years＇ Time Limit 168
Temporary Postponement due to Maladjustment 169
The Man＇s Responsibility：Direct and Indirect 170
Primary and Secondary Sterility 170
General，Functional，or Anatomical Causes 171
Insufficient or Unsuitable Diet 172
Climate 173
Urban Life：Excessive Nerve Strain 173
Alcohol，Nicotine and Drugs 174
In-breeding 174
Age 175
Effects of certain Contraceptives 175
Biochemical and Temperamental Incompatibility 176
Psycho-sexual Factors 177
Psychic Inhibitions 178
Excessive Sensitiveness in the Genitalia 179
Nymphomania 181
Vaginismus 181
Infantilism and Hypoplasia 183
Inherited Tertiary Syphilis 184
General Morbid Conditions 184
Local Abnormalities 184
Infections and Inflammations 185
Importance of Gonorrhoea 186
Injuries to the Ovaries 187
Prevention is the Best Cure 190
APPENDICES TO CHAPTER Ⅵ 190
Reproductive Significance of Vitamine E 190
Industrial and Occupational Injuries to Women＇s Organism 190
Uterine Retroflexion as a Cause of Sterility 191
The Term and Concept of＂Masturbation＂ 192
Simulated Pregnancy，Animal and Human 192
Acquired Uterine Lesions 193
Abortion and Sterility 193
Ovarian Causes of Sterility 193
CHAPTER Ⅶ．STERILITY IN WOMEN 195
PART Ⅱ ITS PREVENTION AND TREATMENT 195
Promptitude Essential in Prophylaxis 195
Strict Cleanliness 195
Effects of Overstrain 195
Infantilism 196
Excessive Prevalence of Arrested Genital Growth 196
Medical Examination before Marriage 196
Exchange of Certificates 197
The Wedding Night and the Honeymoon 198
First Pregnancy and Childbed 198
A Miscarriage needs as much Care as a Full-time Delivery 198
Sterility and Spermatic Saturation 199
General Tonic Treatment 200
Endocrine Therapy 201
Rontgen and Radium Treatment 201
Vibro Massage 202
Treatment for Infantilism 202
Uterine Pessaries 203
Spermotaxis 203
Local and Psychic Interactions 204
Benefits of Iodine Treatment 206
CHAPTER Ⅷ．STERILITY IN WOMEN 207
PART Ⅲ TREATMENT BY SURGERY 207
Dilatation of the Os uteri 207
The Fructulet 207
Curettage and Irrigations 209
Accessory Surgical Measures 210
Tubal Insufflation 211
Tubal Operations 212
Ovarian Operations 213
Ovarian Transplantation 214
Age at Possible Conception 215
Prospects of Success in Prompt Treatment 216
APPENDICES TO CHAPTERS Ⅶ AND Ⅷ 217
Weak Dosages with Rontgen Rays 217
Pessary Treatment of Retroflexion 217
Insufflation of the Oviducts 218
Salpingograms 219
Pregnancies following Regrafts 220
Successful Heteroplastic Ovarian Graft 220
CHAPTER Ⅸ．IMPOTENCE IN MEN 221
PART Ⅰ SIGNIFICANCE，MECHANISM AND PSYCHIC FACTORS 221
Coital Impotence and Procreative Impotence 221
Libido and Erection 221
Ejaculation and Orgasm 222
Absolute，Relative and Temporary Impotence 223
Ejaculatio praecox 225
Its Psychic Basis 228
Impotence in Marriage 229
Selectiveness of Sex Impulse in Men 230
Impotence on the Wedding Night 231
Neurotic Impotence 232
Abnormalities of the Sexual Impulse 233
Homo-sexuality：Innate and Acquired 236
CHAPTER Ⅹ．IMPOTENCE IN MEN 239
PART Ⅱ PHYSICAL CAUSES．TREATMENT 239
General Morbid Causes 239
Industrial Toxins 240
Alcohol 240
Nicotine 240
General and Genital Tonics 241
Endocrine Preparations 241
Hydropathy 244
Independent (Confidential) Reports from both Partners 244
Psychotherapy 244
Benefits and Dangers of Local Treatment 244
Organic Defect 245
Aspermatism and Its Cognates 245
Chronic Alcoholism 247
Gonorrhoea 248
Pathological Changes in the Sperms 249
Necrospermia 250
Venereal Prophylaxis 251
Sperms and Vaginal Secretions．Tests 252
APPENDICES TO CHAPTERS Ⅸ AND Ⅹ 253
Notes on Causation of Impotence 253
The Tragedy of Impotence 253
Momentary Impotence 254
Bridegroom＇s Impotence 254
Some Pharmaceutical Preparations 255
Potency and its Disturbances (Marcuse) 256
Restoration of Vasa deferentia (Fürbinger) 256
CHAPTER Ⅺ．ARTIFICIAL FERTILIZATION，OR INSEMINATION 258
Historical Outline 258
Successes in this Method 259
Indications and Contra-indications 260
Dysgenic Considerations 261
Technique 261
Method of obtaining Seminal Fluid 262
Suggestions as to Procedure 263
Favourable Date in Monthly Cycle 267
Religious and Ethical Objections 268
Defence of Method 268
APPENDICES TO CHAPTER Ⅺ 269
Indications：Quotation from Nürnberger 269
Quotation from Sellheim 269
Quotation from Hirschfeld 270
Papal Decree 270
Quotation from Noldin 271
SECOND INTERMEZZO OF APHORISMS 272
PART Ⅲ THE PREVENTION OF UNDESIRED CONCEPTION 277
CHAPTER Ⅻ．INTRODUCTORY．＂CONCEPTION＂AND＂PREGNANCY＂－＂ASEPSIS＂AGAINST SPERMS 277
What is＂Undesired，＂and by whom 277
Definitions of Conception and Pregnancy 278
How and When does Pregnancy Begin 279
The View of Catholic Dogma 281
The View of Legal Experts 282
From what Date do we Calculate Duration of Pregnancy 283
Pregnancy begins with Implantation，not Fertilization 283
Summary and Definitions 285
The Basis of Contraception 285
Asepsis and Antisepsis 287
Aspermatic and Antispermatic Methods 288
CHAPTER ⅩⅢ．THWARTING THE CONCEPTION BY SPECIAL TECHNIQUE OF SEXUAL INTERCOURSE 290
Complete Abstention from Coitus 290
Abstention from Coitus，but not from Contact and Caresses 291
The Unsafe Period 292
No Reliable Intermenstrual Dates 292
Prolonged Lactation 293
Suction without Lactation 293
＂Karezza＂and Mazdaznan Coitus 294
Coitus interruptus 295
Its Wide Prevalence and Harmfulness 295
Modern Modifications 296
Coitus interruptus prolongatus 296
Unadvisable as a Constant Habit 298
Harmful Suppression of Orgasm in either Partner 298
Crucial Points：Exact Region of Ejaculation？ 298
Angle or Direction of both Organs 299
Contra-indications 300
Urgent Warning against Violent Movements 302
Danger of Vaginal Rupture 303
Anatomical Contraceptive Technique 304
Positions and Attitudes 305
Converse Position：Normal Attitude．Attitude of Extension or Supination 305
Attitudes of Flexion 307
Attitude of Equitation 307
Sedentary Attitude 307
Anterior-lateral Attitude 308
Note on Incompatibility of Flexion and Contraception 308
Averse Position：Coitus a tergo 308
Ventral Attitude of Woman 308
Posterior Lateral Attitude 309
Kneeling and Knee-elbow or Quadrupedal Attitude 309
Active Expulsive Movements post-coitum 310
Posterior Sedentary Attitude 311
Comparison of Converse and Obverse Positions with Anatomical Contraceptive Technique 313
APPENDICES TO CHAPTER ⅩⅢ 314
Contraceptive Efficacy of Safe Period 314
Damage of Coitus interruptus to Women (Kehrer) 316
And to Men (Marcuse) 317
Notes on Prolonged Coitus without Ejaculation 317
＂Australian Movements＂ 318
CHAPTER ⅩⅣ．CONTRACEPTIVE APPLIANCES AND METHODS：MECHANICAL AND CHEMICAL 319
There is no Ideal or Perfect Method of Contraception 320
Essential to avoid Direct Ejaculation into the os uteri 320
Mechanical Occlusion alone is not dependable 321
Mechanical Methods：The Condom Sheath 321
Technique of Coitus condomatus 322
Advantages 323
Defects 323
The right to the Semen：＂Seminal Hunger＂ 325
A Second Line of Defence：Simultaneous use of Chemicals 327
The Mensinga Pessary or＂Dutch Cap＂ 328
History and Description 328
Medical Supervision in its Choice 329
How long should the Mensinga remain in situ 331
When should it be introduced 332
Advantages and Defects of Occlusive Pessaries 333
The Ramses and Matrisalus Pessaries 334
Occlusive and Supporting Pessaries 335
Cervical Caps or Portio Protectors in Rubber 336
Comparison and Criticism of these Appliances 337
Their Difficulties of Insertion and Adjustment 339
Metal and Celluloid Cervical Caps 340
Method of Application 341
More Complex Patterns of Cervical Cap 341
Chemical Methods should be combined with Caps 341
How long should they remain in situ 342
Safety Sponges 343
Chemical Methods and Preparations 343
Quinine 344
Glycerine－Gelatine Fluids 345
The Vaginal Suppository on a Cocoa-butter Base 345
Its Defects and Insecurity 345
Recipes for Chemical Contraceptives 346
Gasogenous Tablets 347
Contraceptive Jellies 348
Method of Insertion 351
Vaginal Douches 352
Technique of Douching 353
Intra-uterine Apparatus 354
Obturators 355
Dangers of all Intra-uterine Studs 356
Silk and Silver Intra-uterine Rings 357
Dangers of this Method 358
Cauterization of the Uterine Lining 359
Intra-uterine Procedure should be undertaken by Qualified Physicians alone 362
APPENDICES TO CHAPTER ⅩⅣ 362
Suggestions as to the Use of Occlusive Pessary 362
The Use of the Rubber Cervical Cap 363
Notes on the Efficacy of Certain Contraceptives (from Report of Breslau Gynaecological Society) 364
CHAPTER ⅩⅤ．PERMANENT SURGICAL STERILIZATION 366
Medical Indications 366
Social and Eugenic Grounds 367
Tubal Sterilization：Its History and Results 368
Excision of the Pars interstitialis Uteri 370
Other Modifications 371
Criticism of Tubal Sterilization 372
Operations on the Ovaries 373
Operations on the Womb 373
Surgical Sterilization of Men 374
Indications 375
Sterilization by Treatment of Uterine Mucosa 375
Electro-coagulation 376
The Tubal hystereoscope 376
Advantages of this Method 377
CHAPTER ⅩⅥ．TEMPORARY SURGICAL STERILIZATION 378
Definition 378
Indications 378
Temporary Sterilization Preferable to Permanent 379
Possible Modifications：Region and Procedure 380
Van de Velde＇s Operation：Ovarian Encapsulation 381
Littauer＇s Operation：Tubal Re-implantation 382
Other Methods 384
Criticism of Methods and Suggestions 385
Reasons for preferring Ovarian to Tubal Operations 387
Blumberg＇s Method 388
Temporary Surgical Sterilization of Men 389
The Mika Operation 390
Reasons against this 390
Synopsis of Matter on Surgical Sterilization 392
CHAPTER ⅩⅦ．TEMPORARY STERILIZATION THROUGH BIOCHEMICAL METHODS 394
Absorption of Spermatozoa 394
Active Immunization against Spermatozoa 394
Spermatolysins and Spermatotoxins 395
Brief Duration of Immunity 396
Passive Immunization 397
Hormonic or Endocrinological Sterilization 398
Haberlandt＇s Experiments 399
Ovarialoptones and Placentaroptones 401
Dangers of this Method 401
Sterilization by Pancreatic Hormones 403
The Male and Female Specific Sex Hormones (Steinach) 403
Summary and Conclusion 405
CHAPTER ⅩⅧ．STERILIZATION BY RADIOTHERAPHY 406
Rontgen Castration and Rontgen Sterilization 407
History of this Method 407
Psychic and Physical Results 409
Temporary Sterilization after Weak Dosage 410
Its Duration 410
Its Uncertainty and Dangers 411
Injury to the Germ Plasm：before and after Conception 411
Radium preferable to R6ntgen Rays 414
Advantages and Disadvantages of Radium Treatment 415
Rontgen Sterilization of Men 417
CHAPTER ⅩⅨ．RECAPITULATION AND CONCLUSION．AUTHOR＇S VIEW OF THE PROBLEM OF ARTIFICIAL TERMINATION OF PREGNANCY＆Translated by C．A．Bang 418
The Present and the Future 419
Importance of Skilled Medical Advice 419
The Duty of Medical Advisers：Should Pregnancy be Prevented，and，if so，how 420
Panel Patients and Hospital Patients should be able to have this Advice 422
University Schools of Medicine and Clinics must co-operate 422
Systematic Enlightenment of： 423
Married Couples 423
Medical Profession 423
Officials and Social Workers 423
＂Ton Corps est à toi＂－The Author disputes this View 424
The Unborn Child is a Living Human Being 424
The Harmful or Fatal Results of Unskilled Interference 426
Indications and Reasons for Legitimate Interference 427
Termination of Pregnancy and Prevention of Conception 429
The Lesser Evil to be preferred to the Greater 430
APPENDIX TO CHAPTER ⅩⅨ 430
Quotation from Lehmkuhl＇s Moral Theology 430
EPILOGUE 433
BIBLIOGRAPHY AND REFERENCES 435