Quinlan, John F.

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The Linacre QuarterlyVolume 8 | Number 1 Article 2January 1940A Reply to Dr. George W. Kosmak on "BirthControl"John F. QuinlanFollow this and additional works at: http://epublications.marquette.edu/lnqRecommended CitationQuinlan, John F. (1940) "A Reply to Dr. George W. Kosmak on "Birth Control"," The Linacre Quarterly: Vol. 8 : No. 1 , Article 2.Available at: http://epublications.marquette.edu/lnq/vol8/iss1/2THE LINACRE QUARTERLY A REPLY to Dr. George W. Kosmak on "Birth Control" By JOHN F . QUINLAN, M.D. San Francisco, California I want to take obj ection to some of the statements which Doctor Kosmak made in his recent article on birth control-and on the basis tha t he, himself, emphasizes that the discussion be held - common sense and r eason. On the " safe period" he says: " no condemnation by church au· thorities a ttaches to the practice of this method of contraception by married people." This IS equivalent to . saying that the Church cannot condemn, if rightly understood, a licit, natural act. As married partners have the right to the climacteric expression of con-jugal love, it is theirs to exercise as often, as seldom, or as oppor-tunely as they may will to do. The exercise of sexual temperance con-sequent upon the knowledge of the contingent law of generation ("safe period") cannot, therefore, be considered "contraceptive" in the same light as is the employ-ment of artificial means. The statement that the endorse-ment of this method by "promi· nent Catholic clergymen and phy-sicians . . . assumes, of course, that the time of ovulation can be determined absolutely in all cases," can be in view of all that has been written-particularly Dr. Latz' booklet "Rhythm," by which this method was most popularized-only a metaphysical (ethical) prejudice intruding itself into a dispassionate scientific discussion, which is confirmed by his assump-tion that results a re "glibly 'cla imed" for it. All of the tables indicating the " safe period" on the basis of the fact of an ovula-tory-menstrual rhythm, demon-strate the relativity of the proc-ess. Nowhere in any of the ex-planatory literature is there a statement quite as dogmatic as "While ovulation in most cases oc-curs during the middle of the in-termenstrual month"- nor one displaying such an ignorance of the basic fact regarding the "safe period." An intermenstrual pe-riod of twenty-one days implies that ovulation occurs on the sev-en th day after the last p eriod, or on the fourteenth day removed from the approaching period; a forty-day intermenstrual period infers that ovulation occurs twenty-six days after the past menses or fourteen days before the forthcoming period. In other words, ovulation is r elated only to the expected p eriod. As it is im-possible actually to determine the day of onset, with reasonable ac-curacy, it can be estimated from the average of the variations in a [ 9 1 1 I II I ! ! I THE LINAGRE QUARTERLY sufficient number of 1·ecent past successive experiences. The confusion that attends the consideration of this subject arises from a misconception of what is meant by the " safe period." There are two safe p eriods in every cycle - immediately following and im-mediately preceding menstruation. They depend, relative to absolute insurance against conception, upon the distance from or close-ness to the onset or cessation of flow. The "middle" of the inter-menstrual p eriod is the most pro-pitious for conception-the fertile or unsafe period. Aversion against the employment or endorsement of this method arises from the mis-conception of the imperiousness or uncontrollability of the sexual ap-p etite to which Dr. Kosmak sub-scribes while considering the " safe period," but which he inferentially denies in his discuss ion of the other methods. Continence only is the physio-logic method. Coitus interruptus (withdrawal), onamsm, mutual masturbation, cannot be consid-ered physiologic; nor is continence in all circumstances. It cannot be where the mutual will of the mar-ried partners to abstain is absent. The conflict of the emotions en-genders a psycho-physical discord destructive of integral health. Normal or health-promoting sex-ual experience is contingent upon the mutuality of desire or, at least, the absence of any revulsion or re-pulsion on the p art of the woman. Too long has it been considered that intercourse is the occasion only of conception or casual and irresponsible pleasure. "Desi re" is a word in belle lettres which has its physiologic equivalent in "ap-petite." It is satisfied only when the need is met. Sexual des ire (amorousness, petulance, rcstiYe-ness, disturbing lumbo-sacro-ili ac and crural sensations and leg pains, etc.-sexual t ension) arises in the woman as the express ion of a physical need; in the man, as the expression of a physical ex-cess. Both appetites (desires) a re satisfied in normal or natural union. Any other method, though it afford the occasion of immediate physical r elease and relaxation for the man and an uncertain thrill for the woman, must r esult in the development of an insatiability with its concomitant brutality a nd moroseness, on the one hand, or on the other, satiety with its correlatives, indiffer ence a nd de-jection. Since ther e can be no physical sati sfaction for the woman, either because withheld or as the result of chemical destruc-tion, the consequ ences for her are either apathy (neurosis or depres-sion) or excitement (hysteria or mania). "Methods in U ·e": One basic consideration is ignored in the en-dorsement of all the a rtifi cia l methods: the copulatory organ of the female, wherein the cervical os is artificially scaled, does not dif-fer in kind from the curled fingers of the solitary male pervert, nor does the penis, sheath ed in a con-dom, differ appreciably from any phallus. Furthermore, the nor-[ 10 1 T THE LINACRE QUARTERLY mal or natural disposition of va r-ious structures of the sexual ap-p ar atus det ermines conscious un-concern r esp ecting them or their function. The presence of any for-eign body-or of a pathological condition-engenders the fixation of attention up on them. Since, in the absence of denudation, the sen-sat ions aroused a r e altogether pleasurable, vary ing degrees of nymp hom ani a a nd 'otherwise in· comprehended irritability result. . The discuss ion of any method involving the use of chemicals must include the consideration of the ap p lication of the laws of chemi-ca l r eactivity not only with r e-spect to the immedia te end sought -the destruct ion of sp ermatozoa - but a lso the 1ocal and g eneral immedia te a nd dist ant effects upon t he woman's ti ssues . The vagina is a highly a bsorbent ti ssue. The insertion of chemicals destroys the sperma tozoa onl y as a physiologic entity; it des troys the naturalness of the r esultant components of the reaction between the vaginal fluids and the semen, a nd inj ects a n un-natu ral component in the reac-t ions within the woman's ti ssues subseq uent to absorption . Ionic t r ansmig ra tion is dep endent upon a tomic size, and fixation upon in-solubility-not in water or Ring-er 's solution or lipoid solvents-hut in that complex liquid, the fl uid t issue of the body . Electro-stasis (chemica l neutraliza tion) determines the a rres t of funct ion o r growth. The fixation of a con· traceptive elemental ion in a n un -fertilized ovum may be the distant cause of physical abnormalities of arrest in the new-born, as the cy-clic hydrocarbons may be the cause of abnormalities of growth. These are not idle speculations, but logical inferences from par-thenogenesis a s well as more r e-cent experiments on the physical and chemical initiation of cell di-vision (prolifer a tion) in the un-fertilized egg. With r espect to the advisability of the preventa tives of conception in the presence of coincidental dis· ea ses, it need only be said that a ny measure which is destru ctive of the best interest of the normal in-dividual cannot poss ibly ser ve the well-being of the sick. The prepondera nt small fa mily in our social economy may be one of the most a pposite causes of the prevalence of juvenile delinquency. There a r e not sufficient exp eri-ences in a small unified socia l fr amework (fa mily ) for t he devel-opment of an adequa t e concept of ethical, socia l rela tionships through the n a tural and progres-sive process of education. One of the chief r easons why the profession has lost est eem with the laity is due to our proneness to resort to measures which flatter the desires (pass ions, emotions-unreasonable demands) of our p a -t ients, r a ther than to adher e t o the precepts of a r a tional prac-tice. No consider a tion of sympa· thy or expediency should sway u s in the a pplication of our skill. Should they do so, we will p ay, as we are now, for the public's dis-illusionment a nd loss of confidence. [ 11 l ~ I THE LI NAORE QUARTERLY As an illustra tion of the rela-tion of this phase of medicine to economics and the degree of re-sponsibility we, as physicians, have in the matter, I am adding a few of my observations in study-ing the subj ect of slum clear ance . The problem of the slums re-mains insoluble because of an ig-norance of, or an unwillingness to define " slum" . Ignorance, be-cause the r apidity with which changes occur does not permit the necessary leisure for reflection and the development of critical in-sight; unwillingness, because clois-t ered in a comfortable sufficiency , we fear to scrutinize lest we see something that might shock us from our complacency, or threat en our own security. The bri ck stru ctures east of Grand Avenue on Market Street in St. Louis, or facing the gully which is the railroad's right of way, were as sightly when new as a rc the government's housing proj ects in some of our east ern cities. And the latter will be as unsightly in a gener ation as a r e the former now, because housing is not the answer to the slums. Human ingenuity and migration will conspire to des troy their value and fitness for abode. The destruction of Today's shambles only makes more room for To-morrow's, as long as we refuse to face the problem squarely. True, there is need of houses, many of them, for the poorest especially , who a re not being provided for. Therefore, there is r eason t o fear t hat the p resent p rogram, in its play to vulture interest s, is not so concerned with housing as a p a r-tial answer, as it is in putt ing capital to work in the interest of an ephemeral r ecovery. The problem of the slums is the M achine that made them and thei r disappearance will come with its control. Slacken its speed. Force it to serve the publi c welfa re a nd much of the enerva tion and de-featism which occas ions t he hor-rible degradations of the human personality-which is the : lum-will disappea r. As there is no in-dustry in the United States whi ch is not subsidized in one way or another by the F eder a l Gove rn-ment, no management should (:n-joy the absolute right a rbitra rily t o apportion the returns of in-dustry . Defin e " equitable income and profits" and ma ke them t he limits of legality . Then if sal-a ries and profits must bulk large it will be as the reward of indus-try , and not as the tribute of ex-ploitation . H ad the r epresen ta-tives of government been less avaricious from the beg inning of industrialism in J cfferson's ad-ministration, the p roblem would not be the monst er it is toda y. N or would we be faced with s t ill a nother - an exc rescence of in-dustrialism - contraception , th an which there is no g reat er cause for the dissolution of the ethi cal concepts and moral st anda rds up on which Society is based. Y ou cannot install machiner y in enry civilized country on the globe and fos t er birth control , and then ex-pect as a result, a st able indus-[ 12 1 1'HE LINACRE trial economy. ·wealth is the product of man's labor only. It can be maintained only by nations enjoying a normal and increasing fertility, co-ordinately with the increasing efficiency of the ma-chine. Decrease their number as an accompaniment of mechaniza-tion and automatically the charges against their productivity - the nation's accumula t ed reserve of wealth- are increased and gradu-ally they become exhausted. Destruction was the fate of Sodom and Gomorrah for their sexual perversionf And just as a curse followed the fir st contracep-tionist who spilled his seed on the ground, so it has followed his 20th century counterpart, who spills it into condoms or. on to "jellies for feminine hygiene". No 20th cen-tury scientific " enlightenment" or social "emancipation" will thwart the inevitability of eff"ect from cause in the realm of nature, whether it be in economics, p sy-chology, or chemistry. Enerva-tion, physical and mental, is a pronounced feature of contempo-rary society. It differs in degree only from a more pronounced form recognized as depress ive in-sanity, the result of man's in-humanity to man, or of personal PHILADELPHIA GU ILD The Guild of Sts. Luke, Cosmos and Damien it attempting to fur-ther its work by having four meet-ings a year, bes ides the a nnual Spring R etreat. Its last R etreat was exception ally well attended a nd there was a thoroughly en-QUARTERLY irra tionability. Insidious corro-s ion results from chemical reactiv-ity in human tissues . During the last 40 years, the p eriod of indus-trialization and the enslavement of man to the machine and the sporulation of the slum, the degen-erative diseases ha ve r eplaced the infectious diseases as the first cause of death. During the las t 20 years (1935), the p eriod of most intensive industri a lization, cancer jumped from fifth to sec-ond place, and the age at which it occurs was lowered five years. In the decade ending in 1936, deaths from cancer of the womb rose fmm 12,634 to 16,280, an increase of almost 30 % . In the same dec-ade, the number of our institution-alized insane inct·eased 40%. These a re the facts with which we should wrestle in our consider-ation of the slum- the result of a disordered industrialism, conse-quent upon inept government and venal representation . Its solution will be effected when our school s, r evising the objectives of educa-tion, will send into public life men who will not se ll the general wel-f a re for a pittance, a peck of votes, or any othe r personal preferment. thusias tic spirit a mon g the mem-bers that promises well for the future of the Guild. At the break-fas t which followed the corporate Communion, Dr. F. F. Borzell, then President of the Philadelphia County Medical Society, addressed the Guild. 13 I 

A Reply to Dr. George W. Kosmak on  Birth Control

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A Reply to Dr. George W. Kosmak on Birth Control

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