Page:Contraception; 1st ed. (IA in.ernet.dli.2015.94163).pdf/136

sometimes inflammatory. Furthermore, for use by a couple where the man is rather small and the woman either naturally big, or as a result of several childbirths has a considerably stretched vagina, the excessive lubrication of the greasy pessary is liable to reduce the efficiency of the coital act by reducing the normal contact and friction. On the part of the woman: those with marked prolapse may find them useless. Contraceptives of any sort for such women are a specially difficult problem (see also p. 191).

Then among normal women the use of the quinine pessary is sometimes inadvisable where the woman is one of those whose systems reject quinine, for there is no doubt at all that some of the quinine is absorbed through the vaginal walls and penetrates the system. I know from a number of cases that sleeplessness, and in a few cases, more acute symptoms result from the use of any form of quinine either orally or per vaginam. This I noted in general in "Wise Parenthood" in 1918, and have since had several interesting confirmatory cases.

Case 3023.—Healthy, aged 23, very anxious to use quinine and cap together as I advised in "Wise Parenthood," "because