Family Limitation
by Margaret Sanger
Eighteenth Edition
REVISED
1914
The preponderance of evidence shows an association between douching and numerous adverse outcomes. Most women douche for hygienic reasons; it can be stated with present knowledge that routine douching is not necessary to maintain vaginal hygiene; again, the preponderance of evidence suggests that douching may be harmful. The authors of the present review believe that there is no reason to recommend that any woman douche and, furthermore, that women should be discouraged from douching.
-- Vaginal Douching: Evidence for Risks or Benefits to Women's Health, by Jenny L. Martino and Sten H. Vermund
As a columnist, [Freda Bedi] addressed women's issues with a directness which was startling. Throughout 1943, she had a weekly column in the Tribune entitled 'From a Woman's Window which tackled issues -- such as childbirth and breast-feeding -- which rarely surfaced in the mainstream media at that time. But her focus on gender, and the unfair and unequal burden on India's women, was evident much earlier. Throughout her adult life, she sought to extend the bounds for women in public life. It would be difficult to describe Freda as a feminist. In her marriage, she willingly embraced a subservience to her husband and his personal and political ambitions. When she argued for women's interests, it was not on the basis of a principled demand for equality but of a measure more equity and respect. As a Tibetan Buddhist, she eventually found a comfortable niche with a distinctly patriarchal spiritual tradition which -- as with most major religions -- limited and confined women's role. Yet her championing of women, and her campaigning for the redress of women's grievances, was a consistent aspect of her life, and first became evident as an activist and writer in pre-independence Lahore.
In the spring of 1936, eighteen months after arriving in India and just a few weeks before Tilak's death, Freda was prominent in a public debate on the desirability of birth control clinics. The event was organised by the medical college students' union, and addressed a pressing issue in an era of large families and high infant and maternal mortality. 'Mrs Freda Bedi said that birth control did not mean no babies, it meant better babies; it did not mean no motherhood, but sensible motherhood. Birth control clinics should really be called "sensible motherhood clinics". Motherhood should be a glorious fulfilment of all that is best in woman and a source of vitality and joy and woman should not be condemned through relentless and machine-like production of children. The way to ensure this was to have efficient birth control clinics established in the Punjab where the service should be absolutely free.'2 There was lively opposition to her argument, with speakers expressing concern about birth control being sinful, leading to sterility and frustrating India's need for a large army, but the chair of the meeting declared that the general sentiment was in support of the clinics.
A couple of months later, Freda wrote for the Tribune's magazine section as part of a debate about the segregation of the sexes. 'All healthy minded people must agree,' she declared, 'that it is best if girls and boys can mix freely socially, while keeping a good attitude towards one another .... To my mind, co-education from childhood upwards is the only solution.' But swayed by her experience as a college teacher, she was also concerned that women students were ignoring skills such as cooking and sewing.The trouble with the present system is that a young man is usually faced with the alternative of a young modern educated wife, who has no idea of running a home intelligently or of bringing up children well, or on the other hand of a pretty girl, very uneducated, who can cook, sew and manage and bring up children but will live a life very apart from him, and be quite unable either to act as a hostess to his friends or to educate his children in the way he would like. I believe that in modern India, a wife, if she is to be useful must be educated, but I am shocked at the way girls in college here neglect learning household affairs. After all, the majority of girls are going to be married and it is only kindness to their husbands to be and their children that they should know something of the more practical things of life.3
In comments that must have upset some of her students, Freda went on to say that the 'trouble is that, because higher education is something of a rarity here still, girls become swelled-headed and think that they are sure to marry rich husbands and that it is below their dignity to work in the house.' This combination of progressive and traditional outlooks was a hallmark of Freda's take on life, and evident in it is how she saw her own role in the household, as her husband's companion and collaborator, but also as the homemaker.
As for the role of women outside the household -- and particularly whether in such a conservative society, where purdah was still common, educated girls should pursue careers -- Freda encouraged young women to seek out occupations which did not excite 'undue opposition from the family and society'. When asked which avenues were open to women, she replied: 'All avenues, ultimately. They have to be fought for, or even just recognised. At present teaching, medicine and nursing hold the field. Journalism is also beginning to attract writers .... Journalism for women, the development of a women's angle in a daily newspaper is a work of which any woman might be proud. It is a national service.'4
That drew a sharp riposte from a student at Fateh Chand in an article provocatively headlined 'The Amazon, grave danger to womanliness':It is significant that in its most loathsome and unacceptable form the suggestion for feminine careers has come from Mrs Freda Bedi, a Western-bred lady. Though, happily, she has united herself to an Indian, and she may be thinking she has 'naturalised' herself to Indian sentiments of life and living, yet the Western influences that moulded her in her childhood and adolescent years have indelibly determined the make-up of her mind and by the very laws of her being she cannot but look upon things with a vision that must needs have a taint of Westernism in it. Mrs Freda Bedi, let us not forget, has a good deal of selfless socio-political public service in Indian interests to her credit, and we revere her on that account. But we should be wary of accepting her views that may tend to disturb our accepted notions of social propriety that are peculiar to our native genius.5
That must have stung. A student at her own college insisting that Freda was not Indian, could never be Indian, and dismissing her arguments not simply on their merits but because they were tainted by her roots in an alien and uncomprehending West.
The opportunities particularly for educated young women, and the need to balance the desire for a career with domestic and household skills, was becoming an increasing focus of Freda's writing. In the summer of 1938, she published a 150-page book entitled the Modern Girl's Guide to Home-Making -- an advert declared that this 'profusely illustrated and practical book should be given to every bride in her dowry and to every growing girl for her birthday'. She also became chief advisory editor to a new Lahore-based monthly journal, Modern Girl.6 No copies of either have been located, so their contents have to be gauged on the basis of reviews. The market for English books and journals was necessarily restricted to Lahore's educated elite. This was not an attempt to address village India, or even the emerging lower middle class, but more the graduates of Fateh Chand and their families.
The reviewer in the Tribune was unconvinced by Freda's Guide. The book addressed the problems of home-making and how they could be surmounted; included recipes, 'exclusively English'; and dealt with home decorating, furnishing and colour schemes in a manner which suggested that 'only a large house and a lot of furniture of different kinds can make a home'. That wasn't the only aspect of the book that jarred. 'She has given an illustration of a typical English kitchen which is rare in India, as also the bath-room and the lavatory. It is submitted that such things are not suited to this country where the poor constitute an overwhelming majority. Besides it is not possible, except for the very rich, to have a sitting-room, dining-room or a bed-room of the type illustrated.' When Freda herself lived so simply in the Model Town huts, it's surprising that she chose to commend a vastly more expensive lifestyle -- this was perhaps the brief that the publisher had insisted upon. The book also offered advice about diet and menus, though the food recommended was expensive and made no provision for vegetarians; there was a 'slimming without tears' section; and a guide for domestic staff about 'how to wait at tables'.7
The monthly magazine appears to have had a similar style and agenda -- though it was received more warmly by the Tribune, which said it filled 'a long-felt want in Lahore society circles and should be eagerly read by educated women all over India. As Mrs Freda Bedi has put it, the "Modern Girl" aims at pointing the way to the true modern girl, the Indian wife and young mother, who has the future of the nation in her pretty hands.' The articles in the first issue covered fashion, the 'place of art in Indian homes', and a topic 'dear to every young girl ... "How to become a Modern Venus"'.8 The journal didn't prosper. A year after its launch, Freda wrote on 'Modern Girl' headed paper to tell Olive Chandler that the magazine had closed.I had no financial interest, being in an advisory capacity only, but it had a lot of me in it, + really fulfilled a long felt need -- practical home-keeping, child-upbringing, modern news + views, for that rather pathetic creature the 'educated' Indian girl, who is brought up on books + examinations + is often unable to create a new + satisfactory home life for herself in the midst of old prejudices + antiquated methods. It was widely appreciated + quite unique but alas! However, I don't despair. They are seeds, + somewhere, somehow, they will bear some kind of fruit.9
Freda had identified a need, and a way of addressing it, but the readership simply wasn't there in sufficient numbers. It was another twenty years before Femina found a way of making a women's magazine work in the Indian market.
-- The Lives of Freda: The Political, Spiritual and Personal Journeys of Freda Bedi, by Andrew Whitehead
There are three methods of birth control:
1. Absolute continence.
2. Sterilization.
3. The use of appliances that prevent conception.
INTRODUCTION
Birth Control or family limitation has been recommended by some of the leading physicians of the United States and of Europe. While the medical profession as a whole has not yet taken a united stand upon the subject, we know that the practice of birth control has already been incorporated into the private moral code of millions of the most intelligent and respected families in every country.
There is little doubt but that its general practice among married persons will shortly win full acceptance and sanction by public authorities, who will encourage the practice among the diseased and unfit and help to direct the movement into its proper channels.
In cases of women suffering from serious ailments, such as Bright's disease, heart disease, or tuberculosis, the physician usually warns the woman to guard herself against pregnancy. It is an established fact that two-thirds of the women who die from the above-named diseases do so because they have become pregnant. Therefore, it is imperative that physicians should not only warn women suffering from these diseases against pregnancy, but they should see that they are properly instructed in methods to prevent conception. Such responsibility on the part of physicians would reduce the maternal mortality of the world tremendously.
While the above-named diseases are not considered transmissible from the mother to the child, there are certain other diseases and conditions such as insanity, syphilis, idiocy and feeble-mindedness which are passed to the next generation.
When either the man or the woman is afflicted with any one of these diseases, it is absolutely wrong to allow a child to be born. In such cases the man or the woman should be sterilized.
The patient should understand that such an operation does not deprive him or her of sexual desire or expression. It simply renders the patient incapable of producing children.
To conserve the lives of mothers and to prevent the birth of diseased or defective children are objects for which we need a sound educational campaign for Birth Control.
We hold that children should be:
1. Conceived in love.
2. Born of the mother's conscious desire.
3. And only begotten under conditions which render possible the heritage of health.
We want parents to be conscious of their responsibility to the race in bringing children into the world. Instead of being a blind and haphazard consequence of uncontrolled instinct, parenthood must be made the responsible and self-directed means of human expression and regeneration.
TO THE WORKING WOMAN
The need for safe practical information on birth control is more urgent today among women than it has ever been before.
The working man and woman have begun to realize the difficulty of supporting a family of eight or ten children on a wage scarcely sufficient to decently keep two or three. They have begun also to realize that no increase of wages, obtained through long days of toil or through strikes or lockouts, can keep pace with the increased cost of living or the cost of an ever-increasing family.
It is the big battalions of unwanted babies that make life so hard for the wife of the workingman. It is the ever-increasing number of children, coming year after year into her life, that perpetuates poverty and misery and ignorance from generation to generation.
The working mother knows through her natural instinct that she should not have more children than her husband's wages can support, yet she does not know what she can do to prevent conception. When she asks her friends or neighbors for advice, she is given remedies, usually unscientific, unauthoritative and unreliable, which her experience or knowledge warns her may be injurious.
So she is thrust back upon the possibility of taking drugs for producing abortion, or resigning herself to all the children nature will give her, which can mean from ten to twenty in one woman's lifetime.
These women resent the fact that the educated women are able to obtain safe, scientific, harmless information of birth control, while Society condemns its use among the working women who need it most. Present-day society is generous in doling out pittances for the unfit and diseased, thus encouraging their multiplication and perpetuation, while it prevents and discourages the use of scientific knowledge which would enable mothers to avoid bringing into the world children they cannot feed, clothe or care for.
I give herewith the knowledge obtained through study and through more than fourteen years' experience as a trained nurse in U.S.A.
Next, she applied for a job as a nurse-probationer at a small local hospital. Again, though, Margaret’s careless and nomadic rootlessness was telling. Hospital work proved to be even more vexing and taxing than teaching. She never finished her training. In later years, however, she would claim to be a trained and practiced nurse. Nearly forty pages of her Autobiography were devoted to her varied, often heroic, experiences as a seasoned veteran in professional health care. But they were little more than Margaret’s well-realized fantasies.
In fact, her actual exposure to medicine was almost nonexistent: she never got beyond running errands, changing sheets, and emptying bedpans. Like so much else in the mythic fable of her rise to prominence, her career as a nurse was little more than perpetrated fraud.
-- Killer Angel: A Biography of Planned Parenthood's Founder Margaret Sanger, by George Grant
With the help of her older sisters, she attended Claverack College and Hudson River Institute in 1896 and then entered the nursing program at White Plains Hospital in 1900. In 1902, just months before completing the program, she met and married architect William Sanger. Margaret Sanger and her husband had three children and the family settled in Hastings, a Westchester County suburb of New York City.
-- About Margaret Sanger, by The Margaret Sanger Papers Project
My own experience as a mother of three children has modified some of the advice given in books.
It is my intention to present the facts to the reader in the simplest language, leaving out dogmas or religious accompaniment.
While there are various mechanical instruments such as the gold, ideal or wishbone pessary, the uterus button, etc., often used to prevent conception, I will not describe them here, because my experience has taught me that they are likely to cause irritation and trouble to the woman. There is sufficient information given here, which, if followed, will prevent a woman from becoming pregnant unless she wishes to do so. It must not be forgotten that the best results can be obtained only when the woman will see that, in every case, she follows directions. She must not get careless even once, for it needs only one union in twelve months, unprotected, to give a woman a baby each year. Therefore, to protect herself from pregnancy the woman must use care constantly.
While it may be troublesome to get up to douche, and a nuisance to have to watch the date of the menstrual period, and to some it may seem sordid and inartistic to insert a pessary or a suppository in anticipation of the sexual act, it may be far more sordid and the condition far worse than inartistic a few years later for the mother to find herself burdened down with half a dozen "accidental" children, unwanted, helpless, shoddily clothed, sometimes starved or undernourished, dragging at her skirt, while she becomes a wornout shadow of the woman she once was.
It takes but a few years of continued pregnancies to break a woman's health. The drain on the family income is continually increasing and the standard of the whole family is lowered.
Mothers! Do not be oversentimental in this important phase of hygiene. Learn the facts of pregnancy. The inevitable fact is that, unless you prevent the male sperm from entering the womb, you are liable to become pregnant.
Women of the working class should not have more than two children today. The conditions of society do not render possible the proper care of more than this number. The average wage-earner can take care of no more than this in decent fashion.
It has been my experience that women desire only the number of children they can properly care for, but that they are compelled to have them from carelessness or through ignorance of the methods to prevent conception.
It is only the workers who are ignorant of the means to prevent bringing children into the world. It is also mainly their children who fill the child labor records, the factories, mills, jails, hospitals, poor houses. It is the workers' children who compete with their parents in the labor market for their daily bread, thereby reducing the wages of the parents — an inevitable consequence when the supply is greater than the demand.
Women of the world arise! Let us close the gates of our bodies against the diseased, the unfit, and bring to birth only the best, as we know it, which should be, at least, a child with a sound body and a sound mind.
IS THERE A SAFE PERIOD?
There is current among people an idea that conception does not take place at certain times of the month. For instance: the interval between ten days after the menstrual period, and four or five days before the next period. This is not to be relied upon at all, for it has been proven again and again that some women conceive at any time in the month. Do not depend upon this belief, for there is no scientific foundation for it. There is also the knowledge that nursing, after child-birth, prevents the return of the menstrual flow for several months and conception does not take place. It is well not to depend upon this too much, especially after the fifth month, for often a woman conceives again without having "seen anything" or without her realizing that she has become pregnant. She thus finds herself with one at the breast and another in the womb. Use some preventive.
COITUS INTERRUPTUS
Perhaps the most commonly used preventive, excepting the use of the condom is "Coitus Interruptus" or withdrawal of the penis from the vagina shortly before the ejection of the semen. No one can doubt that in theory this should be a perfectly safe method; and we also find authorities who claim it is not injurious to the man, but who object to it on the grounds of lack of satisfaction to the woman.
The claim is that if she has not completed her desire, she is under a highly nervous tension, her whole being is perhaps on the verge of satisfaction when she is left in a dissatisfied state. This, without doubt, does her injury. A mutual and satisfied sexual act is of great benefit to the average woman, the magnetism of it is health-giving.
When it is not desired on the part of the woman and she gives no response, it should not take place. The submission of her body without love or desire is degrading to the woman's finer sensibility, all the marriage certificates on earth to the contrary notwithstanding.
During several years past, however, I have come in contact with thousands of men and women who have given me their confidence and experience along these lines. The consensus of experience seems to be that there are many men who prefer to practise the method of withdrawal and have been able to control the ejaculation until after the woman's orgasm. If this is done all objections affecting the woman's satisfaction are of course removed. But the fact remains that even in such cases, with the strongest control on the part of the man, we find that pregnancy does take place. This is often due to some slight disposal on the part of the man to a seminal leakage, in which the spermatozoa escape from the male organs without the man's knowledge and before the ejaculation.
A woman physician examined a vaginal passage and found sperm deposits when absolutely no ejaculation had taken place. The results of these inquiries are sufficient for us to say that the practice of withdrawal cannot always be counted upon as a safe preventive.
Again, while in the quest of information regarding this practice, I have had many men say that their nervous system had suffered decidedly bad effects from this method and upon using another, at once an improved condition was felt.
Here we see how very individual all methods of contraception really are. What may give happiness and good results to one may prove injurious to another. But coitus interruptus or withdrawal, is by no means to be counted upon as either the safest or the best method of preventing conception. There are other methods more to be recommended.
A DOUCHE IS A CLEANSER— NOT A PREVENTIVE
Although an antiseptic douche is an important factor in preventing conception, it should not be relied upon as a preventive measure in itself. A douche is a cleanser, but it is not of itself to be advised as a reliable method to prevent conception. When one understands how conception takes place, it can be seen at once that it is quite possible for a woman to be in a state of pregnancy before she leaves the bed, or before she can reach a douche, unless the womb has been previously covered with the rubber pessary, or by the ingredients of a suppository.
Nevertheless, every woman should learn to cleanse herself thoroughly by means of the vaginal douche. Some women object to the use of the suppository because of its lubricant effect; this can be modified greatly by the use of a warm salt douche, taken just previously to inserting the suppository, cleansing the parts thoroughly of any secretion already there.
Every woman should possess a good two-quart douche bag, called a fountain syringe. Hang it high enough to secure a good, strong, steady flow.
Bulb syringes, such as the whirling spray syringes have been found satisfactory by many women for the purpose, especially where there is no bath room or toilet conveniences, as the bulb syringe can easily be used in the privacy of one's bedroom over a vessel. Directions for use come with each syringe.
HOW TO TAKE A DOUCHE
If you have bathing conveniences, go as quickly as possible to the bathroom after the sexual act and prepare a douche. Lie down upon the back in the bath tub. Hang the filled douche bag high over the tub, and let the water flow freely into the vagina, to wash out the male sperm which was deposited during the act.
Do not be afraid to assist the cleansing by introducing the first finger with the tube and washing out the semen from the folds of the membrane. One can soon learn to tell by the feeling when it is sufficiently clean. It is said, that the French women are the most thorough douchers in the world, which helps greatly in keeping the organs in a clean and healthy condition, as well as preventing the male sperm from reaching the womb to mate with the ovum.
When there are no bath room conveniences, a douche can be taken over the toilet, or, when that is impossible, it can be taken over a vessel in a squatting position.
DOUCHES
Many women have been advised by physicians to use an antiseptic douche as a means to prevent conception. I do not advise any woman, who desires to avoid pregnancy, to rely upon a douche for a contraceptive. I wish to emphasize again that a douche used alone is not a contraceptive, because the germ from the male may already have entered the mouth of the womb before a woman can use a douche. Therefore it is absolutely necessary that some method be used to cover the womb.
A douche is a cleanser. It is a means of hygiene rather than a preventive. Do not depend upon a douche to prevent conception. Some women have been successful in using this for many years and then later on, to their surprise, find that pregnancy has occurred. The explanation is as follows:
When the womb is placed high out of the vagina it is not so easy for the germ from the man to reach directly into the womb. In such cases it is possible for a woman to get up and prepare a douche before the germ from the male enters the womb. There are times, however, when a woman has been standing on her feet, washing or ironing or working, and becomes over-tired. Under such circumstances the womb is pulled or dragged down into the canal of the vagina. At such times if intercourse takes place, it is much easier for the seed from the male to enter directly into the womb, unless there is some protection. It is then that a woman who has previously depended upon a douche as a preventive finds it has failed.
My advice is: Never depend upon a douche alone. It should be used after the use of a suppository or before the removal of the pessary.
Cold water douches are not advisable, as there is a tendency to chill and shock the nervous system. A warm or moderate douche is better.
Warm soapsuds as a douche are used by women in France in the rural districts — just plain common soap, as a cleansing douche after the act.
SOLUTIONS FOR DOUCHING
Following are some of the solutions to be used for the douche, which, when carefully used, will kill the male sperm or prevent its entering the womb:
Cresol is said to be the equivalent, chemically, of lysol and is likely to be obtained at a lower cost. Directions are much the same as those for the use of lysol.
Zonite. — This fluid can be obtained at drug stores and is recommended as a douche and for hygienic purposes generally. A quarter of a glassful to two quarts of warm water is enough, though a stronger solution will do no harm.
Chapter X: Lysol and Zonite
Mrs. Robert Smith, married for two months, and living in a small Colorado town, was turning the pages of the Ladies Home Journal. She came to a picture of the Dionne quintuplets. She was a normal young woman and these engaging babies appealed to her. But just the same she found herself hoping that she wouldn’t have a baby until Robert was earning a little more than $28 a week. Their old family doctor had been of no help, and Mrs. Robert Smith had never heard of a birth control clinic, so she clipped the coupon at the bottom of the page and sent for the booklet containing “facts about Feminine Hygiene and other uses of Lysol.”
“Your ritual of personal antisepsis,” the booklet told Mrs. Smith, “Must cleanse thoroughly, destroy germ-life, and leave you soothed and refreshed. Obviously, the effectiveness of your practice of feminine hygiene depends on the preparation you employ in your douche. LYSOL is ideal for this purpose.”
Mrs. Smith bought a bottle of Lysol. She was sure that it must be a good product or it would not be advertised in the Ladies Home Journal and other magazines that she and her mother had read for years.
Just what is this Lysol, used by the Mrs. Robert Smiths of our country “as a means to intimate feminine daintiness and peace of mind”? It consists essentially of cresol, a distillate of wood and coal, which has been made soluble in water by treating it with soap. Cresol was discovered through the attempts of scientists to find a substance which would not be so poisonous as carbolic acid and yet as effective in killing germs. It is now recognized to be almost, if not equally, as dangerous as carbolic acid itself; swallowing Lysol has come to be a common – but extremely painful – means of committing suicide.
Lysol is “SAFE,” says the Lehn and Fink Company, makers of this product. It takes more than the word “safe” in capital letters to refute the many cases, in medical literature, of injury and even death from Lysol. The United States Dispensatory reports the death of a woman from using Lysol in a vaginal douche. As long ago as 1911 Witthaus and Becker stated in Medical Jurisprudence, Forensic Medicine and Toxicology that they had collected the reports of eleven poisonings from uterine irrigations with Lysol. Five of the poisoned women died. In the Journal of the American Medical Association (June 29, 1935), Dr. Louis Pancaro tells of the death of a young woman who injected Lysol into her uterus in order to bring about an abortion. Within half an hour of doing so, the girl became delirioius and unconscious, and died two days afterward without regaining consciousness.
Any antiseptic should be considered not only from the point of view of its effect on bacteria, but also from the point of view of its action on the body tissues. Obviously, any antiseptic which does more damage to the body tissues than it does to the invading bacteria is dangerous. Dr. John R. Conover and Dr. John L. Laird in the Therapeutic Gazette for February, 1924, had this to say of the phenol group of antiseptics: “Members of this group while efficient in destroying bacteria are equally deleterious to animal tissues … Phenol and cresol, as well as the modified preparations, Lysol, kreso, izal, creolin, etc., have an irritating and toxic action …”
The mucous membranes of the vagina are considered so sensitive and easily injured that the Council on Pharmacy and Chemistry of the American Medical Association will not authorize the advertising of any antiseptic to the public for use on the genito-urinary tract. Yet Lehn and Fink, makers of Lysol, urge frequent vaginal douching with their caustic product.
As pointed out in Chapter 8, douches containing strong antiseptics are a common cause of leucorrhea. Dr. Samuel R. Meaker reports in the Journal of Contraception (March, 1936) that he has seen four or five cases of severe inflammation of the vagina “following the employment of a coal-tar-product widely advertised to the laity for feminine hygiene.” He does not name the product, but the description would fit either Lysol or some very similar product. The woman who follows instructions enclosed with each package of Lysol and douches “several times a week” will not find the treatment “soothing.” But she may discover that the douches have brought on an inflammation of an originally healthy vagina.
If the vagina is already inflamed, and the woman troubled with leucorrhea, douching with a caustic substance such as Lysol is apt to aggravate the condition. Dr. James E. King in the New York State Journal of Medicine for February 11, 1933, said that even doctors sometimes err in this direction in their treatment of leucorrhea. “He [the physician] fails to visualize the irritated vaginal walls and the denuded areas, and prescribes a douche that is irritating. Iodine, Lysol, or some douche powder is often his choice.” Dr. King points out that the use of such agents on inflamed surfaces is so irritating that it actually increases the amount of discharge.
“It is used in delicate childbirth when feminine membranes are most sensitive. Then surely it is safe for normal everyday use.” This, or a similar statement, has appeared in many Lysol advertisements in an attempt to reassure women regarding the safety of the product. A truer statement would be that it has been used in childbirth, but that this use is now largely discredited. Dr. Lawrence P. Garrod, Lecturer in Biology at the St. Bartholomew’s Hospital in England says: “To those familiar with the properties of germicides the use of Lysol in obstetrics has always appeared mistaken. It is the most caustic of all antiseptics in clinical use, with the single exception of phenol, and the limitations imposed by this property on the strengths of solutions employable bring them dangerously near a point at which they are ineffective.” Dr. Garrod, in a study which he made of the efficiency of antiseptics used in midwifery, found that a dye known as brilliant green proved to be over fifty times as effective in killing germs as Lysol. Dr. J.M. Munro Kerr reports that when St. Mary’s Hospital in Manchester, England, substituted Lysol for another antiseptic at childbirth, the fever rate became very much higher.
Many doctors have abandoned the use of antiseptics in the vaginal canal during childbirth, for they have found that frequently the damage to the delicate cells of the vagina and cervix is greater than the damage to the bacteria which may be present. Too often the antiseptics cause the very infection they are supposed to prevent.
Every reader of the popular women’s magazines probably remembers the long series of ads which the Lysol makers ran a year or two ago called “frank talks by eminent women physicians,” which were all based on the inference that women could free themselves of the fear of unwanted pregnancies by using Lysol douches. These advertisements were strikingly similar in some respects. For instance, in all that we have seen the doctors quoted were from foreign countries: Dr. Anne Marie Durand-Wever, “distinguished German gynecologist;” Dr. Anna Baltischurler, “leading gynecologist of Switzerland;” Dr. Clotilde Delaunay, “leading gynecologist of Paris;” Dr. Paul Karniol-Shubert, “one of the most distinguished gynecologists of Austria;” Dr. Louise Foucart-Fassin, “leading gynecologist of Brussels;” Dr. Amparo Monmeneu, “famous gynecologist of Madrid, Spain.” One would think that America had no gynecologists of distinction; or perhaps American names are not sufficiently bizarre to embellish a Lysol advertisement.
Another marked similarity is the sameness of the testimonials from these doctors, even in the phrases they use. Thus the Austrian, Dr. Paula Karniol-Shubert, says of one of her patients: “Sound advice on marriage hygiene was all she needed. And that was all I gave her. In two little words: Use ‘Lysol.’” And Dr. Clotilde Delaunay of Paris says that her advice to her scores of patients “is given in two short words – use ‘Lysol.’” That two doctors of different countries should express themselves in such nearly identical language should certainly be investigated by the Society for Psychical Research as a striking illustration of thought transference.
“The Lysol advertising, playing up the testimonials of foreign physicians, is reminiscent,” says the Bureau of Investigation of the American Medical Association, “of what the Fleischmann people were doing in recent years, and some others long before them. It seems likely that ‘patent medicine’ concerns have to resort to testimonials from foreign physicians because reputable ones in America will not sell themselves out to such schemes. It appears, also, that the foreign physicians’ testimonials are not often found in publications issued in their own countries. Possibly they hope that their fellow countrymen will not see their testimonials in American periodicals.”
In these, and many other advertisements, it is implied that Lysol is a safe contraceptive measure. The same inference is made in the leaflet in the Lysol package when it says: “The douche should follow married relations as a cleansing and antiseptic agent.” We have already pointed out in the chapter on douching that no douche, no matter what it contains, is an effective contraceptive, for frequently the spermatozoa have entered the uterus, made their way into the Fallopian tubes and impregnated the ovum before any douche can reach them. Or they may have found their way into some of the innumerable folds of the vagina. No douche can be depended upon to penetrate all of these folds, despite the very brash and positive assertion that “Lysol has that rare quality of penetrating into ever crevice and furrow of the membranes, destroying germ-life even in the presence of organic matter.”
Even putting aside the fact that the douche is an unreliable contraceptive, Lysol is less effective than many other chemicals. In a study of the spermicidal powers of a group of chemicals, Dr. John R. Baker has found that seventeen are more efficient than cresol in killing spermatozoa. (As said before, Lysol and cresol are essentially the same.) Such a harmless substance as the citric acid of lemons ranks ahead of cresol. Yet the manufacturers of Lysol advertise:Women are sensitive – shy. Down deep in their hearts they know what’s the matter. But something keeps them from telling – even their doctor – and from listening to her advice when she has guessed the truth. Such a case came to my notice recently. I could see my patient thought it ‘wasn’t nice’ to face the problem of marriage hygiene frankly. So I sent for her husband. ‘I’m sorry I had to send for you,’ I told him. ‘But your wife won’t listen. Now you must teach her what to do.’ I explained about ‘Lysol’ – the antiseptic that can always be trusted. I told him how safe it is – how gentle. I told him that the whole medical world approves, uses, recommends it. He went away comforted. And when I next saw his wife, her fears had vanished like dew in the sun. They had both grown young again.
Such sentimental trash would be laughable were it not for the tragedy of the many women who have become pregnant because they have relied upon antiseptic douches.
Two doors from the home of the hypothetical Mrs. Robert Smith who bought Lysol lived Mrs. David Jones – also a typical American wife. Her attention was caught by the picture of a beautiful and radiant woman proclaiming, “Now I’m so much happier.” Mrs. Jones, who had four children, was also struck by the caption, “It’s never too late for a wife to learn.” She read the advertisement and found that Zonite is both “safe and powerful.” And so she bought a bottle.
What is Zonite which the Mrs. Joneses of the country have been told provides the “ideal combination of strength and safety” needed for the purpose of feminine hygiene? It is essentially sodium hypochlorite in water, a very cheap solution. For many years hypochlorite solutions have been known to be of value in the treatment of infections, but they were also known to have decided drawbacks – they were unstable and deteriorated rapidly, and they contained free alkali, which is irritating to body tissue. During the war two surgeons evolved a hypochlorite solution which has been named after them – the Dakin-Carrel solution, and it was used with success on wounds. Zonite is essentially a double-strength Dakin-Carrel solution.
The Zonite Corporation claims that Zonite “keeps its strength indefinitely.” William H. Zabel has reported the experience of St. Luke’s Hospital in Chicago with hypochlorite solutions. St. Luke’s Hospital has tried various processes for making Dakin’s solution, and has also investigated the “concentrated stabilized solutions that are available to be diluted for use.” The judgment formed as the result of this investigation was that “Dakin’s solution, regardless of the method of preparation, loses its efficiency after forty-eight hours, and on longer standing, secondary products form which irritate the wound. Adding chemicals to stabilize the solution interferes with the reaction on micro-organisms.” It is difficult to see in the face of such evidence (confirmed by reports from other scientists) how the claim that Zonite keeps its strength indefinitely can be substantiated. And the chance that a woman can get a fresh bottle of Zonite is extremely small. Quite possibly the bottle has stood on the druggist’s shelf for several weeks, or even longer. At the best it is as old as the time it has taken it to pass through the hands of the manufacturer, the wholesaler, and the druggist.
Zabel reports that Dakin’s solution can be made with an electrolytic cell for about four cents a gallon. Zonite, also manufactured by an electrolytic process, sells for 30 cents for a two and one-half ounce bottle and 60 cents for the six-ounce size. According to Zabel’s cost estimate, and allowing for Zonite’s double strength, the bottle retailing at 60 cents contains about one-half cent’s worth of the solution.
All doctors know that if Dakin’s solution is to be used successfully it must not contain caustic alkali, and its strength must be maintained within a very narrow range. If it is too weak, it is ineffective; if too strong, it seriously irritates the tissues. Many doctors do not use Dakin’s solution because it is difficult to get just the right strength. It seems almost unnecessary to say that the woman who measures her Zonite with a tablespoon and who makes a rough estimate of the water by merely filling up her douche bag is not able to improve on the doctor’s technique.
What about the claims of Zonite that it is non-irritating? In treating wounds with Dakin’s solution it is necessary to cover the surrounding normal tissue with gauze soaked in Vaseline in order to protect it. Any antiseptic that may injure the skin may certainly irritate the mucous membranes of the vagina. Dr. Robert A. Lambert has reported in the Journal of Experimental Medicine that Dakin’s solution is among the antiseptics which are more injurious to tissue cells than to bacteria. Any woman who douches often with Zonite is running a risk because douching frequently with any antiseptic may be harmful. By killing or injuring the protective Doderlein bacilli, and by possibly irritating the mucous membranes, she is inviting an attack of vaginitis. When the Zonite Products Corporation states that “the douche has become a fixed part of the feminine toilet, recognized as a wholesome, healthful routine;” when they claim that Zonite when used as indicated in the vaginal douche is “non-irritating” and “exercises no harmful effect on the delicate membranes and tissues of the vaginal tract,” they are guilty either of ignorance or a callous indifference to the health of the countless women whom they are trying to enlist as steady buyers.
“Nearly every woman at one time or another is afflicted by leucorrhea (‘whites’), characterized by a whitish, viscous discharge. A Zonite douche will help to relieve the inflammation and to disinfect and cleanse the affected parts. When convenient, a tampon of absorbent cotton may be used. This should be moistened well with the solution…” says “Facts for Women,” the booklet put out by the Zonite Corporation. We have already pointed out the dangers of self-treatment of leucorrhea. Use of the tampon, which would keep Zonite in prolonged contact with the mucous membranes, is particularly unwise. “Caution,” read the Zonite leaflets. “Do not let Zonite come in contact with dyed fabrics; the active principle is a powerful bleaching agent.” Yet no caution is given regarding the possible injury resulting from the introduction into the vagina of a tampon saturated with a solution of the same powerful bleaching agent.
The Zonite people at the present time are basing their appeal to women on the inference that Zonite is a good contraceptive. “Many a home is peaceful and happy … when fear and doubt no longer cloud the young wife’s outlook.” The continuous barrage of such statements justifies a final reminder that the douche is not a reliable contraceptive measure. One advertisement reads: “There are sensitive women everywhere who do not trust the superficial information that is going around about feminine hygiene. These deep-natured women want the whole truth from the scientific standpoint. They must depend on themselves to sift out the read facts.” It is to be hoped that enough has been said to make women, deep-natured or otherwise, realize that for the facts they must go elsewhere than to the Zonite Products Corporation.
-- Douching with Lysol and Zonite, Chapter X, in Facts and Frauds in Woman's Hygiene, by Rachel Lynn Palmer and Sarah K. Greenberg, M.D., The Sun Dial Press, New York, 1936
Salt Solution. — Mix four tablespoonfuls of table salt in one quart of warm water and dissolve thoroughly. This is good, and cheap.
I douched with salt water yesterday as I suffer with terrible thrush, now I'm feeling swollen and a bit discormfort. I'm not sure if I did the right thing.
OUR EXPERT SAYS: This is not ideal. You could try one or two drops of tea tree oil in your bath. Otherwise use Canesten pessaries.
-- Douching with salty water, by health24.com
Vinegar Solution. — Many peasants in Europe use vinegar as an antiseptic almost exclusively. One glassful to two quarts of water is the strength usually desired. Douche afterward with clear water.
Acetic acid being the sperm-killing agent in vinegar, may also be used and with the certainty of more uniformity than can be depended upon in the various grades of vinegar. A good solution is one and a half teaspoonfuls of 36 per cent acetic acid to two quarts of warm water.
Plain Water Douche. — This will sometimes remove the semen quite effectively without the aid of an antiseptic. But as the semen can hide itself away in the wrinkled lining of the vaginal cavity, the plain water will only impede its progress for a time. Some ingredient which will kill the sperm is to be more relied upon.
Some women use the douche before the sexual act as a preventive. If this is done, any astringent such as boric acid, alum, citric acid, hydrochlorate of quinine used in the solution will do. Only a pint of solution is needed for this purpose, following the act a larger douche is used as a cleanser. This can also be done with the regular antiseptic douche.