(Kisch, Therapeutische Monatsheft, Feb., 1898, and Sexual Life of Woman; Vinay, Lyon Medical, Jan. 8, 1889); in some cases of heart disease, however, it is possible that, though there is no reason for prohibiting marriage, it is desirable for a woman not to have any children (J.F.  Blacker, “Heart Disease in Relation to Pregnancy,” British Medical Journal, May 25, 1907).

In all such cases, the recommendation of preventive methods of intercourse is obviously an indispensable aid to the physician in emphasizing the supremacy of hygienic precautions.  In the absence of such methods, he can never be sure that his warnings will be heard, and even the observance of his advice would be attended with various undesirable results.  It sometimes happens that a married couple agree, even before marriage, to live together without sexual relations, but, for various reasons, it is seldom found possible or convenient to maintain this resolution for a long period.

It is the recognition of these and similar considerations which has led—­though only within recent years—­on the one hand, as we have seen, to the embodiment of the control of procreation into the practical morality of all civilized nations, and, on the other hand, to the assertion, now perhaps without exception, by all medical authorities on matters of sex that the use of the methods of preventing conception is under certain circumstances urgently necessary and quite harmless.[432] It arouses a smile to-day when we find that less than a century ago it was possible for an able and esteemed medical author to declare that the use of “various abominable means” to prevent conception is “based upon a most presumptuous doubt in the conservative power of the Creator."[433]

The adaptation of theory to practice is not yet complete, and we could not expect that it should be so, for, as we have seen, there is always an antagonism between practical morality and traditional morality.  From time to time flagrant illustrations of this antagonism occur.[434] Even in England, which played a pioneering part in the control of procreation, attempts are still made—­sometimes in quarters where we have a right to expect a better knowledge—­to cast discredit on a movement which, since it has conquered alike scientific approval and popular practice, it is now idle to call in question.

It would be out of place to discuss here the various methods which are used for the control of procreation, or their respective merits and defects.  It is sufficient to say that the condom or protective sheath, which seems to be the most ancient of all methods of preventing conception, after withdrawal, is now regarded by nearly all authorities as, when properly used, the safest, the most convenient, and the most harmless method.[435] This is the opinion of Krafft-Ebing, of Moll, of Schrenck-Notzing, of Loewenfeld, of Forel, of Kisch, of Fuerbringer, to mention only a few of the most distinguished medical authorities.[436]