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the poor and illiterate, often overburdened, women whose husbands are either lascivious, careless or drunken.

The sponge used by itself without any chemical often succeeds, though on the whole it is an insecure preventive. Used in conjunction with a chemical powder, such as alum (see p. 114); quinine powder (see p. 104), or soap powder, or smeared with quinine ointment (see p. 105), soaked in vinegar and water or some other of the many possible spermaticides, the sponge is not only useful but is widely used and is recommended by some of the leading doctors as being the most satisfactory method.

In advising its use great stress should be laid on both the necessity and the difficulty of keeping it properly cleansed. Sponges of the modern rubber tissue have advantages over the natural sponge in being less inclined to harbour putrefying material. A patient should be advised not merely to wash out the sponge, but to keep it in a covered jar of some weak disinfectant such, for instance, as 1 in 20 aqueous boracic acid solution or ½ per cent. lysol.

The sponge is particularly useful for cases of abnormal cervices, either where the cervix is lacerated or proliferated when the application of an occlusive cap (see p. 189) is