Sex efficiency through exercises : special physical culture for women / by Th. H. van de Velde ; [photos, by E. Steinemann].
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much the more valuable and significant, as may be realised from the facts outlined above. Both the simple primary " anal retractions " and Kirch- berg's exercise, as well as the modification of the latter suggested by me, may be performed in the upright position, as well as lying recumbent. I recommend the second position—feet slightly apart—to begin with. It is hardly possible to describe the special vaginal exercises of the pelvic floor in more detail than the general (or " perineal "). Anyone who has once mastered the secret of muscular action and co-ordination has only to apply what she knows. There is, of course, a special muscular sense, which is much more highly developed in some individuals than in others, but it can be cultivated. A certain accurate anatomical knowledge—it need not be extensive—is highly desirable. And knowledge and control will enable the perineal and vaginal muscles to be set in motion separately or together, as the occasion requires. The mind can help the muscles by means of definite • imagery; this is well known in the theory and practice of physical culture. But it is necessary to form an accurate picture of the result to be attained, or the obstacle to be overcome. It may perhaps be simplest and easiest for the woman who is a novice in pelvic physical culture if her physician explains this in the course of a gynaecological consultation. The patient may thus learn how to contract either the " constrictor cunni," the upper " levator vaginae/' and/or the whole pelvic floor. The constrictor cunni muscle is not so difficult to localise and control (see Plates I. and IV.), but she should learn to differentiate between the movements of the constrictor cunni and of the more internal portions of the muscular stratum (Plates II. and IV.), which we have termed levator vaginae, and to activate them separately or together. There is, as a rule, no great difficulty here. But what of cases in which no trained gynaecological or anatomical assistance is available ? In such circumstances I recommend the procedure followed by a married lady and enthusiastic physical culturist about thirty years of age, who