Sex efficiency through exercises : special physical culture for women / by Th. H. van de Velde ; [photos, by E. Steinemann].

But the contractile effect is not felt only in anus and rectum. A similar influence extends to the vagina, although, admittedly, to a lesser degree. This has been proved in the course of gynaecological examinations. I have termed the frontal section of the levator stratum the " Levator Vagina" and depicted it in relation to the surrounding organs in M Ideal Marriage." We shall consider it further in a later chapter of this study. Here it may be mentioned that all these muscles, together with some further lesser muscular portion, shown also in Plate I., form the " muscular pelvic floor," and that the pelvic floor consists further of the tendinous structures shown in Plate IV., and a covering or cushioning of adipose (or fatty) and connective tissues. The pelvic floor is not only the base of the abdomen ; it is also the special support of the internal genitalia, especially the womb and the vagina, and of the bladder, which is closely adjacent to vagina and uterus. These organs receive a strong pressure from the upper abdominal cavity, through gravitational action in the upright position, and through occasional increase of intra-abdominal weight and tension, e.g., in advanced pregnancy. The pelvic floor meets this strong downward pressure with counter pressure, which is quite adequate if its muscles are intact, elastic and well developed. But, if the muscles are slack and the suspensory apparatus of the inner genital organs—especially of the uterus—has been overstrained or impaired, there follow prolapses or displacements, slight or severe, which are always uncomfort- able and sometimes very detrimental both to general health and genital efficiency. Plate III. shows most clearly the risks of injury to the pelvic floor during the process of birth ; for there is tremen- dous forcible distension as the head of the child emerges. Even without the slightest obstetrical knowledge, any observer must realise, from the anatomical conditions alone, that all possible means must be taken both to counteract and repair this—to some degree unavoidable—distension. There is a double need for care and expert cure here : there may be lacerations, both of the perineum and the vagina, which will require careful suturing, and which are still far