soft, and their outer surface, about the fundus, had a partially livid hue. The cavity of the uterus was nearly full of black fluid blood, containing well-formed corpuscles, with an ordinary proportion of white ones. In this blood was a small round mass of soft white flocculent substance, about 1" in diameter, like decidua. It appeared to be formed entirely of cells, like lymph, in various degrees elongated and attenuated, as in the development of filaments of cellular tissues. They were just like those of the deeper layers of granulations, only smaller. The mucous membrane of the uterus appeared pale, but healthy. False membranes were attached to many parts. of its fundus. The closure of these Fallopian tubes accounts for this woman having been barren, though married, and having, notoriously, had frequent intercourse with others besides her husband.-We afterwards learned that she was a woman of extreme sexual passion.

No one has more forcibly attacked the ovular theory than Dr. Ritchie, in a valuable series of papers; he adduces five examples of menstruation, neither caused nor accompanied by ovulation. Thus, in Part I. Section II. p. 652, Medical Gazette, 1844, I find, in the first case, that the woman had menstruated 10 days before death, yet the ovaries presented no external puncture nor cicatrix, although both ovaries were filled with vesicles.

In the second case menstruation had taken place thirteen days before death, but the ovaries showed no puncture nor cicatrix, although containing numerous vesicles, one as large as a garden pea. In the 7th section of Dr. Ritchie's second part, he gives Case No. 1, in which menstruation had occurred six days before death, yet there was no trace of recent ovulation. In Case 7, menstruation had taken place a week before death, but there was neither opening nor scar on the surface of the ovaries. In Case 11, menstruation had occurred a fortnight before death, but the ovaries showed no sign of recent ovulation. On the other hand, the 10 dissections contained in the first section of Dr. Ritchie's papers, show that there may be both ova and ovulation without a vestige of menstruation.

With regard to dissections in confirmation of the coincidence of menstruation and ovulation, Dr. Ritchie says he

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has repeatedly seen the opening into a discharged Graafian vesicle to be still patent, and sometimes the vesicle to be filled with a florid blood clot, in the third and fourth month of pregnancy; and, in one case, he found the corpus luteum of a woman in the ninth month, to communicate with the surface by a distinct foramen. It is thus clear that the mere observation of a rent vesicle filled with blood, at a menstrual period, does not prove that the flow is the result of ovulation.

Dr. Ritchie thus concludes:- "I have shown in the memoirs referred to, that ova are discharged in large numbers from the human ovaries throughout the earliest infancy, in childhood, during amenorrhoea, pregnancy, lactation, and to the utmost term of old age, without giving rise to a coloured uterine discharge; and, on the contrary, that menstruation may be present for as many as eight or nine times consecutively, without the rupture of a Graafian vesicle, and also that this function can be normally performed for the greater part of the whole menstrual life of the woman, although the Fallopian tubes be so agglutinated to the ovaries, or destroyed in their canals, that they are impervious to an ovule. There are a certain number of instances of women having become pregnant before they had ever menstruated at all; others have had all their children, amounting in a patient of my own to five, without menstruating once; and some, again, have been known to fall with child as long as two years after the menses had finally ceased. For these and other reasons on which I cannot here insist, I believe that the hypothesis now spoken of is no more than a pleasing imagination, which will vanish with the light furnished by succeeding inquiries, and that the efficient cause of menstruation will yet appear, and be generally acknowledged to be ovarian, indeed, but not ovular."

Hard pressed by these facts, Meckel admits, "that although ovulation never takes place without inducing menstruation, still it does not take place at every period;" but this is evidently an abandonment of the ovular theory, which is equally attacked by what I call remittent menstruation. When the flow occurs regularly, for years, every fortnight or seven days, is it caused by a fortnightly or a weekly ovulation?

I do not believe it, neither has Négrier adduced facts to confirm his hypothesis that ovulation would so proceed in the two ovaries, that, in one, a vesicle would always ripen, say, on the first of a month, while in the other, a vesicle would not ripen until the 15th. Doubtless at the period of puberty ovula begin to be matured in the ovaria of women, but that these are only matured periodically, is contrary to truth, for it has been proved, by the researches of Dr. Ritchie, that the ovula may be matured and discharged during the intervals of menstruation, and even at periods when that function is not taking place. Carus confirms these assertions, by stating that in the ovaria of girls from two to four years of age, he has observed the follicles fully developed, and the ovule floating in the fluid of the Graafian vesicle.-System des Physiologies, von Carl Gustave Carus.

The ovular theory is also attacked by another form of argument :-" I know of cases," says Dr. Oldham, "which I have carefully inquired into, where impregnation occurred at the respective times of ten, twelve, and twenty-one days after the monthly periods; and while on the one hand I am quite ready to admit a greater disposition to impregnation shortly after a menstrual period, yet I know of no facts to disprove the opinion that the human female is susceptible of impregnation at any time between her monthly periods."

Hirsch-Schmidt's Jahrbuch, 1853, No. 2-has likewise seen a case wherein impregnation took place at the 22nd day after healthy menstruation, and he observes correctly that as the Jewish women are obliged to abstain from intercourse five days before and seven days after menstruation, that race could not be so prolific as it is known to be, if the ovular theory of menstruation is true. Again, if the ovulation theory be true, how can the menstruation which occurs during pregnancy be accounted for?

The possible coincidence of ovulation is proved by the cases recorded by Ecker, Pank, Négrier, Raciborski, Dr. Michel of Charleston, U.S., Dr. Hannover of Copenhagen, Mr. Girdwood, Dr. Letheby, Mr. Whitehead, and many others, but the contradictory facts which I have adduced, and the arguments into which I have entered, unquestionably show that ovulation and menstruation are not convertible

terms, that they relate to phenomena which may be associated with, but are often entirely separated one from the other. Ovulation is common to all animals; is probably rendered more energetic by a higher temperature, more abundant food, and by sexual stimuli. Menstruation, with its peculiar ruling force, its prodromata, attendant symptoms, and critical flows, is peculiar to woman. The more I observe the more I am struck by facts which cannot harmonize with the ovulation theory. I have patients in whom any unusual nervous emotion or over-exertion will bring on the menstrual flow with the usual menstrual symptoms, although they may have only just recovered from this discharge. How can it be supposed that an ovule can be ripened, and the dense ovarian envelop suddenly perforated by the fatigue of a dinner-party, by hearing disagreeable news, or by an altercation with a servant? Am I to suppose that the emerging of an ovule from the ovary causes the floodings of cessation or serosanguinolent discharges, no matter whether they occur every week or every six months.

The laws of ovulation are as yet imperfectly known, but I believe that it proceeds as regularly, fatally, and uninterruptedly as nutrition; whereas the menstrual function shifts its periodicities, returning about the 14th or the 21st day after the last epoch, whether it came at a right or a wrong time. This sudden shifting of periodic action is the special attribute of the nervous system, shows the menstrual flow to be impelled by nervous influence, and explains how a strong emotion may repel the menstrual flow or alter the time of its appearance. That sudden emotion should cause the uterine surface to perspire is only a repetition of the well-known power of emotion on other parts.

Physiologists have puzzled themselves to find the reason of women being subjected to the menstrual function; I need not, however, here discuss the opinion of our countryman, Emett, who supposes that menstruation does not occur naturally, but is the result of social habits, which do not permit women to enjoy sexual intercourse when they feel the want of it. Dr. Leake accounts for menstruation in the following manner:-" It is manifest that the female organs, after a certain age, are so disposed as to prepare a larger

quantity of blood than is necessary for the support and nourishment of the body, which-blood-in the time of uterogestation is consumed by the foetus, and after delivery, by the child; but that this redundant quantity might not incommode the constitution during the time a woman is not pregnant, provident nature has ordered it off by the vessels of the uterus once a month." I might, however, ask Dr. Leake why "provident nature" did not subject other females to the same penalty as woman? If I rightly understand Dr. Ramsbotham, he has lately discovered that "the final cause of the menstrual flow is to nourish the vivified egg, and that when it is not vivified, the menstrual flow passes away by the vagina." An announcement which elicited objections too numerous and self-evident to render it necessary to detail them. I merely object to it on the plea, that cases occur similar to that described by B. de Boismont, of a lady who, during her whole life, always menstruated by the mouth, and yet had a child. Such cases show, that although the menstrual flow indicates an aptitude to conceive, it is useless for the fecundation or for the nutrition of the germ.

Menstruation may serve to teach the female economy how to lose blood with impunity, which is a marked peculiarity of woman. No more can be said. It is better to admit our ignorance, instead of giving as sterling truths the coinage of our imaginations.