4. Soluble Suppositories and Rubber Pessaries.—­It is quite true that the use of a suitable soluble suppository alone may be sufficient to protect against impregnation, but the protection by this means does undoubtedly fail at times, and therefore, by itself, the soluble suppository is unreliable.  Still it eliminates the majority of the chances of impregnation.  The use of the rubber pessary is also sometimes unsuccessful because it does not fit properly, or because it is porous, or because in removing it some of the seminal fluid from the under-surface may be accidentally spilt in the vagina, and in this way the spermatazoa may later find their way upwards to an ovum.  Therefore, the soluble suppository and the rubber pessary should be used in combination.  A woman should first push up, as far as possible, a suitable suppository, and then insert the rubber pessary (slightly soaped—­with soap-suds), so as to occlude the whole of the upper part of her genital passage and thus cover the mouth of the womb and effectively prevent entrance of the spermatazoa.  The rubber pessary must in the first instance be fitted by a doctor, because if it does not fit properly it will be ineffective.  The seminal fluid may pass by its loose rim and impregnation may result.  If the rubber pessary has been properly fitted, and it is not porous, the protection should be complete; but if, by any accident, spermatazoa should get beyond the rubber pessary, they will be destroyed and tangled in the melted suppository—­provided, of course, that a suitable suppository has been used.  It is all a question of getting the right articles to begin with and using them intelligently.  But there is this chance—­a bare chance—­of accidental impregnation, and we want to eliminate all chances, if possible.  Assuming the rubber pessary fits properly, as it will if skilfully selected and applied in the first instance by a competent medical practitioner, then the seminal fluid must remain in the lower part of the vaginal passage.  An hour or two after intercourse, or next morning, this seminal fluid can all be washed away by the use of syringe and bidet.  It is far better to sit over the bidet and syringe in that position than to squat down over a basin—­an uncomfortable and unsuitable position for douching, because the walls of the vagina in that position may be pressed hard together.  The fluid should be retained in the vagina for a minute or two, by pressing the flange of syringe closely against the orifice of the vagina. After syringing, but not before, the rubber pessary should be removed (to be washed with soap and water, dried carefully, and put away till required again), and immediately after removing the rubber pessary it is a good plan to facilitate the ejection of the surplus fat of the suppository by urinating and re-syringing.  It is quite easy for a woman to insert and remove these rubber pessaries for herself as occasion requires, provided that whilst inserting and removing the pessary