Page:Contraception; 1st ed. (IA in.ernet.dli.2015.94163).pdf/161

difficult or impossible. Also for cases where the cervix is depressed or has been removed. If the uterus is not prolapsed, then the sponge is safe and satisfactory for such cases.

In all cases of serious prolapse the sponge ´is useless, and in my opinion, the tradition of its unreliability has arisen from the fact that just the class of woman who tends to use the sponge (the poor and uneducated) tends also to suffer from neglected prolapse, which of course makes the sponge an unsuitable contraceptive, though they do not know that.

Comment.—The sponge is the most suitable contraceptive for various types of cervical abnormality. Nevertheless, in spite of this and of its particular value to poor and ignorant people who cannot afford or who cannot understand more precisely adapted contrivances, I do not greatly favour the sponge myself for general use and think that the internal cap (p. 138) is both more easy to keep clean and in many other ways more advantageous. The sponge, however, is preferable to any of the contraceptive means so far considered in these pages.

The general principle of these is similar to that of the sponge, the object being to