knowledge of such measures will undoubtedly increase the extent of illicit relations, already widespread thru the secret knowledge and practice of such measures. It is doubtful if the fear of supporting a family is a great deterrent to marriage. It seems rather that the knowledge of contraceptive measures, enabling the young couple to indulge in ante-nuptial sexual relations does more. to postpone marriage than the fear of parenthood and the obligations to support a family. The whole question is however academic so far as the medical personal freedom is one of the important matters. It should be regarded as absolute, and they should have to decide for themselves how many children they can bring up and raise according to their ideals. A. RAVOGLI, Cincinnati, Ohio, Emeritus Professor of Dermatology and Syphilology. Both from the moral and from the social standpoints the question of birth control is a very delicate as well as a very interesting one. Morally it touches the reproduction of the species, the most professioin is concerned for the physi intimate social relations between man and cian will follow the dictates of his conscience and reason, irrespective of statute and canon. CARL BECK, Chicago, Illinois, Professor of Surgery, Chicago College of Physicians and Surgeons; founder of St. Anthony's Hospital. As a physician of almost thirty years of practice, I have certain views on the subject. It is better for married people to have children, provided the parents are healthy; it is better to have these children while they are young and fresh in their strength and are able to give them the best of their education; it is better for them to have as many children as they are able to raise properly, according to their wealth, education and to the prospects of the future and to their surroundings. Freedom must be left to the parents in this respect, as every piece of work that a person undertakes grudgingly will not yield such good results as the work that he does with love and devotion. If parents are devoid of such inclinations to bring up large families, they should have the freedom to restrict their families by natural means, of course. This woman. Socially, it affects the interest of society and opens the door to problems of the greatest sociological import. Upon the question of birth control by prevention of conception there are two points of view. On one side there is the stringent financial condition of the parents who are unable to provide for many children. On the other side the children themselves, who in a family where the number of children is small will be better developed, better nourished, better educated and more useful to society as a whole. Indeed the birth control movement has arisen from the fact that the parents and children were called upon to suffer too much. When we see a poor woman in the street so poorly clad that she barely hides her nakedness and see that this woman is pregnant, is carrying one child in her arms and has another one clinging to her skirts and know that she has two or more children in her dark poorly aerated unsanitary rooms which she calls 'home' we can but think of the necessity of relieving such suffering. This cannot be obtained in any other way than by birth control. In these cases birth control is beneficial to the parents as well as to the children for if the number of children in the family be small they can live in better surroundings which will conduce to better health and in the long run to much more useful lives. To obtain birth control two methods are advocated, the artificial and the natural. Altho we do not consider these methods physically injurious we do believe that they are apt to morally pervert the sexual and parental instincts. They inspire only caution in the pursuit of sexual relations and remove all ideals of self control. The artificial devices employed by the woman have a tendency to increase hypersensuality, which in itself is an evil which birth control should reduce. It invites to the sexual act promising the evasion of the normal consequences. It may be considered entirely selfish and classed with over indulgence and abuse of the sexual function. Contraceptive measures may be employed to the limit by vicious men and women. Birth control by the natural method is accomplished by self control. It is simple and natural. Chastity does not harm the body or the mind. Father KARL JENTSCH' has very aptly said that the sexual function has just as little to do with the question of morality as has the function of nutrition. The gratification connected with them, or the desire for that gratification, or the idea of it, cannot be sinful. He does not call chastity the mere disuse of sex functions but their use according to what the an cients called castitas, that is their regulation according to duty and reason. Moderate gratification is not only harmless but necessary. Man must, however, use self control. 1 Father KARL JENTSCH. 'On Sexual Ethics,' American Journal of Urology and Sexology, Vol. XIII, No. 2, Feb., 1917. In a general way we can say that natural birth control is of benefit to the family as a whole to the individual members of the family and to society. A large family with several children in poor health is of no benefit to the family itself nor to the community in which it exists. On the other hand, a small family of healthy, intelligent and robust children is a blessing to all concerned. When a man is able to control himself and is willing to satisfy his sex desire judiciously he has no need of contraceptive means. When a man is not able to do this, contraceptive measures must be used. In this case prevention of conception means self defense for the wife, the weaker sex is here struggling for racial protection. To my mind it is heart-rending to see a poor woman with a babe five or six months old nursing at her breast and the mother pregnant. That woman and her babes need protection from the brutality of a degenerate husband and father who is not able to control his sex instincts. In our opinion the knowledge of birth control has no bearing on the increase of immorality. On the contrary we believe that it leads to morality. We believe that many more marriages would take place were it possible for pregnancy to be avoided for a certain time; if it could be postponed say until the husband had attained to a comfortable financial condition. WILLIAM C. BRAISTED, Washington, D. C., Surgeon General, U. S. Navy; Honorary LL.D., University of Michigan, 1917; President of the Association of Military Surgeons of the U. S.; President of the National Board of Medical Examiners. Your letter contains a series of ques tions of the profoundest interest not only to physicians, legislators and sociologists but to every thinking person. It would be wrong for me to attempt to answer these questions categorically without giving them deep thought and study. There is of course much to be said on both sides of the question and I have the greatest respect for the opinions of all those who have gone deeply into the matter whatever their point of view. It is not a new topic. From the remotest ages and among the most primitive races various methods have been employed to control the population and sex. If in earlier times weaklings were destroyed, or female children killed, it was with a view to promoting tribal interests just as to-day some advocate the prevention of conception with a view to the betterment of the race. I think it must be admitted that in nature sexual gratification exists as an incentive to reproduction and not for its own sake. As a general rule it is a risky undertaking to tamper with nature. Of course civilization and the conditions of modern life have modified man in many ways, but the instinct for sexual indulgence with its consequence, in the healthy, of abundant reproduction remains unchanged. We do not see evil in this, but only in its unbridled gratification. We urge young men to continence and one of the arguments therefor is based on the consequences of the sexual act, reproduction. That is to say, the youth without ability to support wife and child who prematurely and promiscuously gratifies his passion is an evil doer in many ways. Again we appeal to the chivalry of man when we point out that in illegal union the greater burden falls upon the weaker participant and that the woman must bear and rear the child. established, in the sense of teaching the prevention of conception, we make possible all sorts of irregular unions without the deterrent of nature's consequence, reproduction. One is forced to believe that many of the people who are practicing birth control to-day-the practice is widespread and not made a secret of or we would not have so many families boasting only one child or two at the most do so not because they are unable to support numerous children, but because they do not wish to undergo the privations and self-sacrifice that large families may entail and because they do not wish to be tied down by obligations to children. But these self-sacrifices and privations and economies make for the best development of character in the parents, just as numerous brothers and sisters are the best coadjuvants in the bringing up of a child. As a nation we are singularly lacking in thrift and economy. Will birth control tend to correct our extravagance and prodigality? It is incontestable that small families are commonest among the rich, the very class which possesses every material advantage for the proper care, training and education of many children. While, then, we may very readily discover certain economic benefits to be derived from limiting the offspring of the poor and ignorant, and this is the great argument for birth control, we must equally consider the far-reaching results of checking reproduction, as the promulgation of birth control will inevitably do, in the classes best able to properly bring up large families. There is to be considered also the effect on the unmarried. We should reshape many of our standards of right and wrong and modify many of our laws if birth control is to be made The moment that birth control is general. Infanticide is a crime even in a penniless, deserted, unprotected girl, the victim of some man's irresponsible lust. Yet the gratification of physical passion after a hastily enacted civil ceremony would have the approval of society, when it was pure passion robbed of all ideas of mating, home making and child rearing, a legalized perversion of nature's methods. While not prepared to condemn absolutely some sort of birth control you may see from the above that I incline to believe that its adoption might easily lead us into greater evils than those we seek to escape. I incline to believe that nature knows best (and when I say nature I have in my heart a disposition to spell the word with a capital letter or to use a synonym, Providence, God,) how our lives are to be shaped and what influences must surround each individual to develop in him the highest good. I have heard many people say: 'I wish I had had more brothers and sisters,' or 'I wish I had had more children' or 'I wish I had had children,' but I cannot recall ever hearing the wish that there had been no brothers and sisters, no child. I recommend to every student of this subject Zola's powerful work Fécondité. Tho a novel, it is drawn from life and teaches many valuable lessons, one of which is that people sometimes change in their desires, but often their later and better inclinations have become impossible of gratification because of early attempts to have their own way in defiance of nature. vice, for people who have known each other only a few days or weeks, who are financially unprepared to meet the obligations of family life, who give promise of early divorce to marry. By such steps as these we are not repressing nature save as it appears in abnormal, degenerate or irregular forms, and this may well be within the province of civilized man. I think our right to prevent conception generally can scarcely be admitted as . long as we permit any and everybody to marry. In this country above all others do we find abundant examples of attainment and success springing from poverty and obscurity. We boast of how men here may rise from humble sources to the highest position, and glory in the power of native energy and talent to surpass in accomplishment many a man born with the proverbial gold spoon in his mouth. When we establish birth control with the inevitable limitations that attend human effort who can say to what extent we may rob the world of the inestimably valuable examples set by self-made men. Shall we be able to guarantee that in the long run the limited population begotten under the restrictions of birth control will be sufficiently productive of intellectual and physical labor to supply the world's needs? If we survey the history of the world and its progress we must be constantly astonished at the number of men of eminence whose parents begot in poverty a numerous progeny. There have been popes born of cobblers, and artists, scientists, writers, philanthropists without number have blessed the world in spite of and perhaps in a measure because they bore the yoke in their youth, because the small means and the many brothers and sisters compelled them to effort. H. H. HAZEN, Washington, D. C., Professor of Dermatology and Syphilology, Georgetown and Howard Medical Schools; Chairman, Section on Dermatology, American Medical Association. 1. I am neither strongly in favor of the doctrine of birth control nor strongly opposed to it; on many points my mind is not entirely clear. 2. I am inclined to feel that the laws against the dissemination of information regarding contraceptive methods are not equitable, for the wealthy, who are in a position to raise children, can obtain all of the information (and other help) that they may need, while those who are not in a position to obtain such knowledge are those who cannot raise a family to the best advantage, either for the family or the country. 3. Birth control must have a very important connection with the general economic questions; any other view is preposterous. 4. Am still undecided as to the effect on general morality that the propagation of the views might produce. To my mind your letter ignores one very important point, and that is the question as to the authors of literature in regard to birth control. In good hands. this literature can do good, but in bad hands it can do the greatest amount of harm. This latter point has much to do with my indecision as regards to the practability of publishing tracts on the subject. J. WESLEY BOVEE, Washington, D. C., Professor Gynecology, George Washington University; ex-President of the American Gynecological Society. While I believe in the doctrine of birth control, I am not enthusiastic for it. the successful working out of matters pertaining to it by natural methods, I therefore believe its relation to the economic situation is not so important as the ethical issue. I do not think the wide spread knowledge of birth control would result in any material influence on morality or immorality. H. J. BOLDT, New York, Professor of Gynecology, New York Post Graduate Medical School; inventor of many gynecological in truments. I believe in birth control under medical supervision. Birth control is desirable, from my point of view, in instances of hereditary disease of one or both parents. In the case of habitual criminals. In the case of marked neurasthenics. It is my opinion that a widespread knowledge of birth control would be likely to result in an increase of immorality. ROBERT T. MORRIS, New York, Emeritus Professor of Surgery, Post Graduate Medical School; author of a large number of books, the latest being Dawn of the Fourth Era in Surgery, Microbes and Men, A Surgeon's Philosophy, The Way Out of War. 1. The doctrine of birth control in my opinion is not as yet formulated in a way which would entitle it to the dignity of a doctrine. If elimination of the manifestly unfit could be practically accomplished after systematic study of all of the factors involved, there could be little question of the desirability of the movement in the interest of public welfare. 2. In my opinion the laws against the lieving we have numerous instances of dissemination of information regarding |