"In 1909, an authoritative German medical journal, Deutsche medizinische Wochenschrift, published a paper by Dr Richter of Waldenburg (near Breslaw) entitled 'Ein Mittel zur Verhütung der Konzeption' (a means of preventing conception). Because of the taboo surrounding contraception, the very title of the article will no doubt have surprised many readers and shocked some. The device described by Dr Richter was the first genuine IUD. It consisted of two strands of coarse silkworm gut (crin de Florence) wound in a particular pattern, the free ends of which were capped with celluloid to prevent injury to the endometrium. The threads were united by a thin bronze filament to diagnose expulsion and to facilitate retrieval of the IUD, which was inserted using a metal female bladder catheter. Dr Richter's invention had no impact on the practice of birth control and clinical data were never supplied. Contraception continued to use the traditional interuterine devices, for example, the metal wishbone spring pessary patented by Dr Carl Hollweg (1902) and the cervico-uterine pessary made of silkworm gut attached to a cervical glass button described by Dr Karl Pust."