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The psychology and psychopathology of contraception, the special interest of readers of this JOURNAL, receive scant attention in Mr. Scott's vigorously written book. His physiology and pathology are sometimes speculative rather than based upon evidence; for instance, he states that in coitus interruptus the seminal vesicles are left partially occupied by secretions (whereas in normal coitus they are completely emptied) and the mucous membrane of the prostatic urethra is in a state of partial congestion. 'In time, through the continued repetition of these conditions, there arises a pathological hyperæmia of the verumontanum marked by chronic irritability, causing at first rapid and premature ejaculations and ultimately impotence'. He admits that the effects vary enormously in individuals, but quotes no observations in support of his pathology. In women, the author contends, the danger is less and is largely psychological. In both sexes, however, coitus interruptus means an interference with the orgastic process demanding an adjustment which many persons cannot make. The danger was ignored until Freud directed attention to it; but nowadays there is a tendency to exaggerate its ill effects, especially by those incapable of understanding psycho-analysis, but who yet find it fashionable to offer some sexual advice to their patients.
The sociological views are sensible and expressed with some warmth, but with humour and lucidity. Mr. Scott contends that the declining birth-rate is due, in the main, to conditions accompanying civilization with its postponement of marriage and the lowered fertility brought about by 'unnatural environment and unnatural food'. There is no evidence, Mr. Scott contends, that the world's food-supply cannot keep pace with the world's population. Whatever justification Malthus may have had for his fears when he wrote his essay, modern agriculture, chemistry and transport have belied those fears. The author neatly says 'those who advocate