and water, or dirty green water, as in the latter part of the lochial discharge. As, during the dodging-time, the redundant blood cannot, in general, be used or changed into fat, it is expelled, and constitutes various hæmorrhages, or else it produces congestions or discharges, the latter relieving the former. As, for thirty-two years, it had been habitual for woman to lose about 3 oz. of blood every month, so it would have been indeed singular, if there did not exist some wellcontinued compensating discharges acting as wastegates to protect the system, until health could be permanently reestablished by striking new balances in the allotment of blood to the various parts. The compensating agencies may consist of a larger consumption of carbon by the lungs, an increase of urinary deposits, increased perspiration, more abundant mucous flows, and hæmorrhages from various organs. Some of these compensating actions proceed permanently, as from the surface of the lungs and skin; others occur irregularly; but in a certain number of cases the compensating action recurs periodically, assuming the monthly type, the type of the function which is falling into disuse.

DURATION OF MENSTRUATION.

Operating on 177 cases, B. de Boismont found the average duration of menstruation to be about 27 years in Paris. Out of 500 cases, I found it to be nearly 32 in London. also ascertained, that menstruation lasts longest in those who menstruate earliest in this country, for the unanimous testimony of travellers renders it almost certain, that in India, and in tropical countries, cessation often occurs from 30 to 35 years of age.

Thus while in the well-to-do-working population of London the mean duration of the menstrual function is about thirtyone years, in Paris, amongst women principally belonging to the same station, the mean duration is nearly twenty-nine years. It is 23 years, says Raciborski, for the Jewish women in Poland, and 31 for Polish women of the Slavonic race. Dr. Ravn, of Copenhagen, has enabled me to demonstrate that first menstruation occurred in Sweden about 2 years later than in England, and a reference to the fecundity

table of Sweden and Finland does not show that procreative power is prolonged in so northern a latitude beyond the limits which bound it in England and Ireland; I therefore infer that the period of procreative power is also shorter in northern latitudes than in England. In other words, the procreative power of man lasts longer in temperate than in hot or cold climates.

CHAPTER II.

"Propter ovaria sola Mulier est quod est."

THEORIES OF MENSTRUATION.

FOR ages it had been supposed that the womb was principally concerned in the two parallel phenomena of generation and menstruation, but within the last few years it has been proved, that "the ovary is the workshop of generation," and that it contains the inciting cause of menstruation. It is very obvious, that no organ can derive its power of action from any other organ, the appearance of which is posterior to its own, whether in the development of the embryo, or in the successive complication of organs in the zoological series; I may therefore infer that the ovaries, which appear first, impart to the uterus its special power of action. It is also manifest, that every organ receives its stimulus from that which follows it in the successive evolution of other parts of the system, as seen in the development of the embryo. Hence, it is the uterus which stimulates the ovaries to increased action. Moreover, in any series of organs constituting an apparatus, the middle organ is always placed between an organ anterior to itself, from which it derives its ratio standi, its final end—and a third organ, whose development is posterior to its own, and from which it derives its appropriate stimulus. The uterus, therefore, derives its stimulus from the external organs of generation, and the reason of its existence from the ovaries. The relative importance of the organs of generation being clearly established, I shall briefly observe, with respect to the ovaries, that they are throughout the scale of creation the ultima ratio of generation. In woman it has been amply shown, by the successful experiments of modern observers, that the ovaria are the essential organs of reproduction, and that in them originate the greater proportion of those sympathies which have been

so long generalized as uterine; furthermore, that the development of the pelvis, of the uterine system, and of the mammæ, the function of menstruation, and all the peculiarities of the human female, depend upon the ovaria. These may consequently be considered the essential organs of the generative system, for they are always present, whatever form the organization may assume. The ovaria, then, not only supply that pars ventris-as the Roman jurists used to say—which, by the stimulus of the seminal fluid, can be developed into an individual similar to its progenitors, but they also determine the phenomena of menstruation.

With regard to the influence of the ovaria in the production of menstruation, there is not now a dissentient voice; the periodical turgescence of the ovaries, admitted by all whose attention has been devoted to the subject, was strikingly exhibited in a woman who laboured under hernia of the ovary, projecting through the inguinal canal of the right side. -Verdier, Traité des Hernies, 1840, p. 396. The volume of the tumour varied much, but was always observed to be large immediately before the catamenia, to diminish on their irruption, and to become very small indeed when the discharge was abundant. A similar case has been under Dr. Oldham's care for the last year: the central sexual organs are wanting; there is no vagina or uterus; but the two ovaries are external to the inguinal canal, and at the menstrual times, one increases enormously and then decreases.

Nature proves the relative importance of the ovaries and the womb in women who, from some unknown cause, have been congenitally deprived of one or the other of these organs. The following cases of absence, or of a rudimentary state of the ovaries, show, that we are right in recognising, with Owen and Macfarlane, with Lauth, Dance, and Isidore Geoffroy de St. Hilaire, that the ovary is the only essential part of the generative system. In the Repertoire d'Anatomie Pathologique, Tom. V., Lauth gives the following

case:

CASE 6.-A woman dying at the age of fifty-three, had never menstruated nor borne children, and connexion, often performed during several years, gave no pleasure. Her appearance was masculine, skin brown, muscular system

strongly developed, the mammary gland and the nipple and its areola were like those of a man. Her pelvis was also masculine; the subpubic angle, instead of measuring from ninety to ninety-five degrees, as is usual in woman, only measured sixty-three and a half. The external organs of generation were normal; the clitoris well developed; no hymen; the vagina short, but wide and smooth; the uterus bicornate and semi-membranous; no ovaries, the places of which were marked by a small quantity of cellular tissue. Since it is on account of the ovaries, says Lauth, that woman is what she is, no wonder if, in their absence, other important parts of the sexual system should have been, at some very early age, arrested in their development.

In the same journal-Tom. X.-Mr. Renaudin relates a case of abesnce of the womb coinciding with rudimentary ovaries. The woman had never menstruated, the breasts were undeveloped, and the external organs of generation were imperfect. Morgagni relates a similar case.

Thus in absence of the ovaries, the constitution is generally masculine, the womb rudimentary, and there are no menstrual pains, nor any monthly crisis; although cases have been noted, in which there was congenital absence of the uterus, when the ovaries were present, in which the individuals experienced monthly violent pains about the pelvis, and all the other symptoms which accompany ordinary menstruation, though without the sanguineous discharge. The following are instances of the absence of uterus, with the presence of the ovaries:

The ex

CASE 7.-Dance relates-Archives Gén. de Méd., Tom. XX.-that a woman, twenty-seven years of age, died without having menstruated, or without ever having the prodromata of menstruation; though in stature, form, and mammary development, she was a perfect woman. For four years she had lived with a man, and had sexual desires. ternal organs were well formed, but the vagina only consisted of a cul-de-sac, half an inch long. The rectum was found adherent to the bladder; the ovaries and tubes were normal, and they met in a swelling about as big as a nut, which neither presented the form nor cavity of the body or neck of the womb. A case of complete absence of the