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we should have no criminal abortion cases, no womb veils, no tubes with buttons to close the os,<ref>This phrase may be engimatic to the 21st-century reader; the ''os'' refers to the opening of the uterus, and tubes were part of the syringe apparatus that was standard for an obstetric medical bag; see Robert Banres, ''Lectures on Obstetric Operations'' (London, 1871), p. 6 [http://books.google.com/books?id=Bm0oAAAAYAAJ&pg=PA6&dq=%22obstetric+instruments+—+The+obstetric+Bag%22&lr=&as_drrb_is=q&as_minm_is=0&as_miny_is=&as_maxm_is=0&as_maxy_is=&as_brr=1&cd=1#v=onepage&q=%22obstetric%20instruments%20—%20The%20obstetric%20Bag%22&f=false online.] The closing of the ''os'' here, however, seems to mean a measure taken to prevent conception; a procedure that sounds similar is described as an alternative to [[hysterectomy]] in ''The American Journal of the Medical Sciences'' (August 1897), pp. 257–258 [http://books.google.com/books?id=PgkCAAAAYAAJ&pg=PA258&dq=tubes+with+buttons+to+close+the+os&lr=&as_drrb_is=q&as_minm_is=0&as_miny_is=&as_maxm_is=0&as_maxy_is=&num=100&as_brr=3&cd=27#v=onepage&q=&f=false online.]</ref> and the Anglo-Saxon race, instead of being in a decadent condition, would rise in its birth rate and not leave the race problem to the [[Latins|Latin]]-[[Germanic peoples|Teutonic]] and [[colored]] race.<ref>J.P. Oliver, "Shall the Profession Do Contract Work Cheaper Than for the Public" ''Texas Medical Journal'' 22 (1906–07), pp. 139–140 [http://books.google.com/books?id=u6cCAAAAYAAJ&pg=PA139&dq=%22womb+veils%22&lr=&as_drrb_is=q&as_minm_is=0&as_miny_is=&as_maxm_is=0&as_maxy_is=&num=100&as_brr=3&cd=30#v=onepage&q=%22womb%20veils%22&f=false online.]</ref>
we should have no criminal abortion cases, no womb veils, no tubes with buttons to close the os,<ref>This phrase may be engimatic to the 21st-century reader; the ''os'' refers to the opening of the uterus, and tubes were part of the syringe apparatus that was standard for an obstetric [[medical bag]]; see Robert Banres, ''Lectures on Obstetric Operations'' (London, 1871), p. 6 [http://books.google.com/books?id=Bm0oAAAAYAAJ&pg=PA6&dq=%22obstetric+instruments+—+The+obstetric+Bag%22&lr=&as_drrb_is=q&as_minm_is=0&as_miny_is=&as_maxm_is=0&as_maxy_is=&as_brr=1&cd=1#v=onepage&q=%22obstetric%20instruments%20—%20The%20obstetric%20Bag%22&f=false online.] The closing of the ''os'' here, however, seems to mean a measure taken to prevent conception; a procedure that sounds similar is described as an alternative to [[hysterectomy]] in ''The American Journal of the Medical Sciences'' (August 1897), pp. 257–258 [http://books.google.com/books?id=PgkCAAAAYAAJ&pg=PA258&dq=tubes+with+buttons+to+close+the+os&lr=&as_drrb_is=q&as_minm_is=0&as_miny_is=&as_maxm_is=0&as_maxy_is=&num=100&as_brr=3&cd=27#v=onepage&q=&f=false online.]</ref> and the Anglo-Saxon race, instead of being in a decadent condition, would rise in its birth rate and not leave the race problem to the [[Latins|Latin]]-[[Germanic peoples|Teutonic]] and [[colored]] race.<ref>J.P. Oliver, "Shall the Profession Do Contract Work Cheaper Than for the Public" ''Texas Medical Journal'' 22 (1906–07), pp. 139–140 [http://books.google.com/books?id=u6cCAAAAYAAJ&pg=PA139&dq=%22womb+veils%22&lr=&as_drrb_is=q&as_minm_is=0&as_miny_is=&as_maxm_is=0&as_maxy_is=&num=100&as_brr=3&cd=30#v=onepage&q=%22womb%20veils%22&f=false online.]</ref>
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Revision as of 11:33, 27 June 2010

Edward Bliss Foote designed an early form of barrier contraception that he called the "womb veil"

The womb veil was a 19th-century American form of barrier contraception consisting of an occlusive pessary made of rubber. It was the forerunner to the modern diaphragm and cervical cap.[1] The name was first used by Edward Bliss Foote in 1863 for the device he designed and marketed.[2] "Womb veil" became the most common 19th-century American term for similar devices,[3] and continued to be used into the early 20th century. Womb veils were among a "range of contraceptive technology of questionable efficacy" available to American women of the 1800s,[4] forms of which began to be advertised in the 1830s and 1840s.[5] They could be bought widely through mail-order catalogues; when induced abortion was criminalized in the United States during the 1870s, reliance on birth control increased.[6] Womb veils were touted as a discreet form of contraception, with one catalogue of erotic products from the 1860s promising that they could be "used by the female without danger of detection by the male."[7]

The use of rubber pessaries for contraception likely arose from the 19th-century practice of correcting a prolapsed uterus with such a device; the condition seems to have been far more frequently diagnosed than its incidence would warrant, and at times may have been a fiction for employing a pessary for birth control.[8] As with the production of condoms for men, the development of vulcanized rubber by Charles Goodyear helped make barrier contraceptives for women more reliable and inexpensive.[9] Other terms for the contraceptive diaphragm were "female preventatives", "female protectors", "Victoria's protectors", and the "French pessary" ("F.P.") or "pessaire preventif".[10] This linguistic variety, some of it euphemistic, makes it difficult to distinguish in the literature among diaphragms, cervical caps, female condoms, and other pessaries; one form of "womb veil" is described in 1890 as "like a ring pessary covered by a membraneous envelope."[11] Another source in 1895 describes it as "a small soft rubber cup surrounded at the brim by a flexible rubber ring about an inch or inch and a quarter in diameter."[12]

Social history

The Popular Health Movement of the Jacksonian era encouraged the sharing of knowledge about contraception, and contraceptive devices were advertised openly in newspaper ads and in brochures throughout the first half of the 19th century.[13] Among their proponents was the physician Edward Bliss Foote. Foote introduced his device, the womb veil, in a self-published book entitled Medical Common Sense:

This consists of an India-rubber contrivance which the female easily adjusts in the vagina before copulation, and which spreads a thin tissue of rubber before the mouth of the womb so as to prevent the seminal aura from entering. … Conception cannot possibly take place when it is used. The full enjoyment of the conjugal embrace can be indulged in during coition. The husband would hardly be likely to know that it was being used, unless told by the wife. … It places conception entirely under the control of the wife, to whom it naturally belongs; for it is for her to say at what time and under what circumstances, she will become the mother, and the moral, religious, and physical instructress of offpsring.[14][15]

Emma Goldman was among those who promoted the use of "womb veils" as contraception

Foote appears to have been the first to use the term "womb veil", in introducing his vaginal diaphragm in 1863.[16] The explicitness of his description is regarded as "rather remarkable" for its time.[17] Foote touted his device as "the only reliable means yet discovered for the prevention of conception," and sold it "closely sealed" through the mail at a cost of $6. Foote may have gotten the idea for his device from an 1838 German treatise on cervical caps, or from acquaintance with the German tradition of midwifery that had been brought to the United States.[18] Although he mentions his intention to obtain a patent, none is recorded.[19]

"Succinct, straightforward" advertising for birth control devices, as well as for aphrodisiacs and drugs to induce abortion and cure venereal disease, had been common in newspapers of the 1830s and 40s.[20] But in 1873, the Comstock laws made it illegal to disseminate information about contraception.[21] The following year, Foote was arrested and convicted under Comstock.[22] His pamphlets were seized and destroyed, although his descriptions of the womb veil survive in early editions of his book.[23] In subsequent editions, he was required to cut back the section on contraception to focus on douching, usually referred to in the literature of the time as the use of syringes.[24] Retailers were subjected to raids, with womb veils among the contraceptive devices confiscated.[25] Although contraceptive information in popular media was curtailed, technical and medical journals and textbooks were not subject to this regulation, and physicians continued to discuss both issues and technologies pertaining to birth control.[26]

The early 20th century saw a resurgence of interest in birth control in the United States, due largely to the efforts of Margaret Sanger and other social activists. One of the most outspoken advocates for contraception during this time was Emma Goldman, who openly defied the Comstock laws by recommending the womb veil in leaflets she distributed after her lectures.[27]

Efficacy and side effects

The womb veil, described in medical Latin as a type of pessarium occlusivum, was considered by some medical authorities to be effective if fitted and inserted correctly. Post-coital douching was often recommended in conjunction with its use.[28] Prolonged use of the device was reported on occasion to produce side effects, some of which pointed toward a need for better hygiene.[29] Serious ulcerations were reported among those who wore it too long or without proper care.[30] In a report to the New Haven Medical Association, one doctor blamed the womb veil for a woman's nocturnal seizures.[31] A gynecologist noted that the rubber womb veil might cause irritation or itching, but reckoned that the "opportunity for increased or unlimited intercourse" was the proximate cause.[32] Another physician who promoted contraception as a way to avoid resorting to abortion found that some users had been disappointed in the womb veil; he recommended douching as a more effective means.[33]

One physican found the womb veil to be "harmless" and likely "effectual" in some cases, but thought it relied too much on women knowing how to insert it correctly, with the possibility that it might become dislodged during intercourse.[34] Concerns about displacement of the womb veil, as well as irritation and loss of pleasurable sensation, were also expressed by the author of an early 20th-century book on human sexuality.[35] The element of unreliability was recognized in the literature distributed by Emma Goldman.[36]

Concerns about fit were addressed by offering over-the-counter womb veils labeled by size, though not in a standardized way: "big" and "small," "one-size-fits-all," and "mothers' size" were some of the terms used. Symptoms such as cramping, abdominal pain, ulceration, and urinary tract infections were likely to have been caused by a too-large womb veil. The risk of dispacement and consequent pregnancy was increased by a veil too small. By comparison, modern diaphragms require cervical measurement and a prescription from a medical practitioner, and range in size from 50 to 95 millimeters.[37]

Noting that "any preventive will fail if not applied properly," the New York physician and free-love advocate[38] Oscar Rotter offered these instructions:

For introduction, the woman is to sit down, so to say, on her heels, with her legs spread apart, which will bring the womb down as low as possible. Then taking the womb veil into the right hand with the cavity looking upward and compressed from side to side, giving it thus the shape of an ellipse, she has to push it up the vagina as far as it will go. It will then spread out of its own accord and apply itself closely and firmly to the neck of the womb.[39]

Rotter also recommended that the veil be used in conjunction with a spermicide ointment made from muriate of quinine and vaseline.[40] Instructions for removal and hygiene followed.

Rotter was an enthusiastic if careful proponent of the womb veil. Writing in 1897, he recommended pessaries made in England as of the highest quality, with those from Germany also satisfactory. The American in his view were the most poorly made, an inferiority he blamed on the restrictive Comstock laws that drove manufacture and sale underground: "In England, however, where such goods are openly advertised and sold, competition tends to secure the survival of the fittest, and hence it is better to import them from that country." Until legal prohibitions limiting commercial production and distribution were lessened in the 1920s, reputable companies would manufacture devices for contraception only as a discreet sideline. Small-scale entrepreneurs, not excluding black marketeers, stepped in to produce womb veils among other taboo items intended if not explicitly labeled as birth control.[41] For women too poor to buy quality contraception, Rotter also described how to make a homemade device from a rubber ball.[42]

Moral and racialist aspects

The Comstock ban on advertising contraceptive devices, which included womb veils, was not intended to protect consumers from false claims of efficacy, but from exposure to indecency. One editorial writer specifically asserted that even if the ads made true statements, the "anger and indignation of respectable people" at finding such products in their daily newspaper would be grounds to ban them.[43] At Foote's trial, Anthony Comstock himself testified that the womb veil was "an instrument of death both moral and physical to the youth of the land."[44]

The use of womb veils, like other forms of contraception, was thus subject to moral condemnation. In his Ladies' Guide in Health and Disease, John Harvey Kellogg asserted several legitimate reasons for family planning, but considered womb veils and other technological forms of birth control to be harmful both physically and psychologically, causing women to lose "all respect for the sacredness of the maternal function."[45] The author of a Hand-book to Obstetrics (1908) opined:

I think there is a growing distaste for the family duties among women … that should be condemned. The efforts of women to equal man in studies, work, etc., while still claiming their sex privileges, with the dissolution of club and society life, are leading to a 'race suicide.' This ought not to be. Woman is anatomically, physiologically, and emotionally evolved for one sole and single purpose, any departure therefrom being done at the violation of her best ideals and a misdirection of energy.[46]

The author finds the rhythm method ineffective, since "for the female, rut and menstruation are the same." He further disapproves of withdrawal, warning that the latter would lead to "nervous collapse" and noting that "it is infinitely worse than masturbation."[47] The perceived immorality of contraceptive devices was linked to the fear that they might enhance sexual pleasure; like masturbation, the use of womb veils, condoms, and other appliances might "heighten the feeling," but "there is no contact of the parts, and it is morally pernicious and degrading." Because these devices removed the fear of conception, they were said to foster a "positive invitation to illicit intercourse."[48] Although in general douching was more acceptable,[49] even ads for "syringes" could be condemned as being "as hurtful to public morals and children's education as if they advertised condoms and womb veils."[50]

Although birth control was sometimes advocated as a way for the poor to manage their resources better by limiting the size of their family, it could also be promoted for controlling social groups seen as inferior.[51] Observing that a couple "swept away by passion" might not think to take precautions such as inserting a womb veil, and that "the least intelligent" such as "the rough workman or dull peasant" would be most likely not to exercise self-control, one medical writer advocated intrauterine devices that could be left in place "if we wish to breed up not down."[52]

Anxieties about "race suicide"[53] also framed opposition to birth control. The average number of births among white married couples is estimated to have dropped by nearly half between 1800 and 1900.[54] Womb veils were pointed to in racially charged rhetoric warning that contraception threatened the white, specifically Anglo-Saxon, fertility rate. A Missouri physician blamed gynecology as a medical specialty for teaching "young ladies how to avoid conception," claiming that "syringes, sponges,[55] and womb-veils will exterminate the descendants of the Mayflower."[56] An editorial in a 1906 issue of Texas Medical Journal asserted that if all physicians were "both civic and Christian gentlemen"[57]

we should have no criminal abortion cases, no womb veils, no tubes with buttons to close the os,[58] and the Anglo-Saxon race, instead of being in a decadent condition, would rise in its birth rate and not leave the race problem to the Latin-Teutonic and colored race.[59]

In fact, indications are that black Americans also practiced family planning to a comparable degree in the post-slavery period, and several factors seem to have influenced a desire for smaller families among various demographic groups in the 19th century.[60]

See also

References

  1. ^ Janet Farrell Brodie, Contraception and Abortion in Nineteenth-Century America (Cornell University Press, 1994), p. 216 online; Andrea Tone, Devices and Desires: A History of Contraceptives in America (MacMillan, 2001), p. 14. An illustration of occlusive pessaries of the womb-veil type may be viewed in Vern L. Bullough, Encyclopedia of Birth Control (ABC-Clio, 2003), p. 206 online.
  2. ^ Robert Jütte, Contraception: A History (Polity Press, 2008, originally published in German 2003), p. 154 online.
  3. ^ Brodie, Contraception and Abortion, p. 212.
  4. ^ Jeffrey D. Nichols, Prostitution, Polygamy and Power: Salt Lake City, 1847–1918 (University of Illinois Press, 2002), p. 69 online.
  5. ^ Brodie, Contraception and Abortion, pp. 190 and 212.
  6. ^ Esther Katz, "The History of Birth Control in the United States," in History of Medicine (Routledge, 1988), vol. 4, pp. 89–90 online; Andrea Tone, Controlling Reproduction: An American History p. 215 online.
  7. ^ Donna Dennis, Licentious Gotham: Erotic Publishing and Its Prosecution in Nineteenth-Century New York (Harvard University Press, 2009), pp. 215–216 online.
  8. ^ Angus McLaren, "Birth Control: The Diaphragm," in Eyewitness to Science (Harvard University Press, 1995), p. 175; Katz, "The History of Birth Control in the United States," p. 91.
  9. ^ Patricia Aikens Murphy, Katherine Morgan, and Frances E. Likis, "Contraception," in Women's Gynecologic Health (Jones and Bartlett, 2006), p. 177 online; Larry Lankton, Beyond the Boundaries: Life and Landscape at the Lake Superior Copper Mines, 1840–1875 (Oxford University Press, 1997), p. 160 online; Tone, Devices and Desires, p. 14.
  10. ^ Brodie, Contraception and Abortion in Nineteenth-Century America, p. 5.
  11. ^ Brodie, Contraception and Abortion in Nineteenth-Century America, p. 216.
  12. ^ William Pawson Chunn, "The Prevention of Conception. Its Practicability and Justifiability," Hot Spring Medical Journal 4 (1895), p. 83.
  13. ^ Adele Clark, Disciplining Reproduction: Modernity, American Life Sciences, and the Problems of Sex (University of California Press, 1998), p. 167 online.
  14. ^ Foote, Edward Bliss (1863). Medical Common Sense; Applied to the Causes, Prevention, and Cure of Chronic Diseases and Unhappiness in Marriage. New York. p. 380.{{cite book}}: CS1 maint: location missing publisher (link)
  15. ^ See also discussion by Brodie, Contraception and Abortion in Nineteenth-Century America, p. 218.
  16. ^ Lee L. Bean, Geraldine P. Mineau, and Douglas L. Anderton, Fertility Change on the American Frontier: Adaptation and Innovation (University of California Press, 1990), p. 30 online; Vern L. Bullough, Science in the Bedroom: A History of Sex Research (Basic Books, 1994), p. 106 online.
  17. ^ Christopher Hoolihan, An Annotated Catalogue of the Edward C. Atwater Collection of American Popular Medicine and Health Reform (University of Rochester Press, 2001), vol. 1, p. 335 online.
  18. ^ Brodie, Contraception and Abortion in Nineteenth-Century America, p. 218.
  19. ^ Michael Sappol, A Traffic of Dead Bodies: Anatomy and Embodied Social Identity in Nineteenth-Century America (Princeton University Press, 2002), p. 369.
  20. ^ Brodie, Contraception and Abortion, p. 190.
  21. ^ Lis Harris, Rules of Engagement: Four Couples and American Marriage Today (Simon & Schuster, 1995), p. 106 online. As Brodie, Contraception and Abortion, pp. 191–192, notes, even "eminently respectable" publications were subject to accusations. For an editorial fulmination against advertising various remedies for gonorrhea and impotence, with greater indignation directed at even the possibility of exposure to ads for condoms and womb veils ("this literature of sin, a fertile source of immorality"), see "Death to Quacks," Toledo Medical and Surgical Journal 2 (1878), pp. 415–416 online.
  22. ^ John D'Emilio and Estelle B. Freedman, Intimate Matters: A History of Sexuality in America (University of Chicago Press, 1988, 1997, 2nd ed.), p. 161 online.
  23. ^ Bullough, Science in the Bedroom, p. 106.
  24. ^ As in the 1868 edition of Foote's book, p. 381. See Chesler, Woman of Valor, p. 70 online and Hoolihan, An Annotated Catalogue, pp. 335–337; also Tone, Devices and Desires, p. 62.
  25. ^ Brodie, Contraception and Abortion, p. 235; Tone, Devices and Desires, pp. 29 and 41. In March 1878, Anthony Comstock himself raided a druggist and seized an inventory that included six womb veils; another arrest netted 150.
  26. ^ Katz, "The History of Birth Control in the United States," p. 91.
  27. ^ Including Why and How the Poor Should Not Have Many Children; see Linda Gordon, The Moral Property of Women: A History of Birth Control Politics in America (University of Illinois Press, 1974, 2002), p. 148 online, and Ellen Chesler, Woman of Valor: Margaret Sanger and the Birth Control Movement in America (Simon & Schuster, 1992, 2007), p. 88.
  28. ^ F.E. Chandler, review of Die Mittel zur Verhuetung der Conception by Jans Ferdy (Heuser, n.d.), in The Medical Times and Register 32 (1896), p. 258 online.
  29. ^ "Simple erosions, such as arise from the mechanical irritation of a pessary, or from the pent-up secretions incident to the wearing of a womb-veil, are quickly cured by removing the cause and keeping the parts clean": David Tod Gilliam, A Text-book of Practical Gynecology (1916, 5th ed.), p. 237 online. Similar report of "gastric disturbance" that was relieved by removal of the womb veil, releasing "an accumulation of a creamy fluid," verbal reports given 8 February 1887 as published in The American Lancet 11 (1887), p. 177 online.
  30. ^ Kansas Medical Journal, 23 January 1897, p. 47 online.
  31. ^ Medical society reports, Yale Medical Journal 7 (1900–1901), pp. 329–330 online.
  32. ^ William A. Graham, "Etiology of Gynecological Disease," Transactions of the Medical Society of the State of North Carolina (1902), p. 235 online.
  33. ^ O.E. Herrick, "Abortion and Its Lessons," Michigan Medical News 5 (1882), p. 10 online.
  34. ^ Chunn, "The Prevention of Conception," p. 83 online.
  35. ^ Joseph Richardson Parke, Human Sexuality: A Medico-Literary Treatise on the History and Pathology of the Sex Instinct for the Use of Physicians and Jurists (Philadelphia, 1912), p. 176 online.
  36. ^ Gordon, The Moral Property of Women, p. 148.
  37. ^ Tone, Devices and Desires, p. 74.
  38. ^ Rotter was the author of The Sexes and Love in Freedom and Jealousy, the Foe of Freedom; see ad in Dora Forster's Sex Radicalism: As Seen by an Emancipated Woman of the New Time (Chicago, 1905), pp. 59 and 60 online.
  39. ^ Oscar Rotter, "Means of Preventing Conception," The Medical World 15 (1897), pp. 151–152 online.
  40. ^ Rotter uses the lowercase form for "vaseline."
  41. ^ Tone, Devices and Desires, pp. 48–49. Among those retailers subjected to raids and confiscations was an Irishman arrested in 1881 for selling contraceptives from a one-room shop at 489 Grand Street, New York City; his seized stock included 11 womb veils; see Brodie, Contraception and Abortion, p. 235.
  42. ^ Rotter, "Means of Preventing Conception," pp. 151–152.
  43. ^ Unsigned editorial, Saint Paul Medical Journal 3 (1901), p. 687 online.
  44. ^ Janice Ruth Wood, The Struggle for Free Speech in the United States, 1872–1915: Edward Bliss Foote, Edward Bond Foote, and Anti-Comstock Operations (Routledge, 2008), p. 67 online.
  45. ^ John Harvey Kellogg, Ladies' Guide in Health and Disease: Girlhood, Maidenhood, Wifehood, Motherhood (Battle Creek, Michigan, 1901), pp. 345–351, on womb veils p. 349 online.
  46. ^ Rawlins Cadwallader, Hand-book of Obstetrics (1908), p. 260.
  47. ^ Cadwallader, Hand-book of Obstetrics, p. 260. Kellogg had also compared birth control measures to "self-abuse" (p. 351).
  48. ^ Cadwallader, Hand-book of Obstetrics, p. 261.
  49. ^ Cadwallader, Hand-book of Obstetrics, p. 261; Herrick, "Abortion and Its Lessons," p. 10.
  50. ^ John F. Edgar, "Correspondence: The Way of the Irregular, of Any School of Practice, Is Full of Chaos and Boomerangs," "The Medical Forum: A Monthly Journal Devoted to the Interests of the Medical Profession 2 (1905), p. 329 online.
  51. ^ On race, class, modernity, and urbanization as factors in perceptions of birth control, see Katz, "The History of Birth Control in the United States," passim; Tone, Devices and Desires, p. 145ff. More broadly on the subject of eugenics, feminism, and race, see Gordon, The Moral Property of Women, p. 80ff.
  52. ^ Robert L. Dickinson, "Simple Sterilization of Women by Cautery Stricture at the Intra-Uterine Tubal Openings, Compared with Other Methods," Surgery, Gynecology, and Obstetrics 23 (1916), p. 204 online.
  53. ^ Cadwallader, Hand-book of Obstetrics, p. 260 online.
  54. ^ Katz, "The History of Birth Control in the United States," p. 82.
  55. ^ Inserted sponges have been used as barrier contraception since antiquity, when they were often saturated with a fluid, commonly vinegar, aimed at creating an environment less hospitable for fertilization. The sponge was one of the first methods of contraception recommended in printed informational tracts, appearing as early as 1797. See Brodie, Contraception and Abortion, p. 212.
  56. ^ "Dr. George W. Dewey of Moberly District, Mo., thus forcibly descants on some of the delusions of the day," The Medical Record 14 August 1886, p. 196 online.
  57. ^ See also Christian views on contraception.
  58. ^ This phrase may be engimatic to the 21st-century reader; the os refers to the opening of the uterus, and tubes were part of the syringe apparatus that was standard for an obstetric medical bag; see Robert Banres, Lectures on Obstetric Operations (London, 1871), p. 6 online. The closing of the os here, however, seems to mean a measure taken to prevent conception; a procedure that sounds similar is described as an alternative to hysterectomy in The American Journal of the Medical Sciences (August 1897), pp. 257–258 online.
  59. ^ J.P. Oliver, "Shall the Profession Do Contract Work Cheaper Than for the Public" Texas Medical Journal 22 (1906–07), pp. 139–140 online.
  60. ^ Katz, "The History of Birth Control in the United States," p. 86 et passim.
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