rupturing force. The whole of the circumjacent tissue of the ovary was highly injected, and red with full capillaries and small branches,

Fig. 47.

B

as is commonly found to be the case. I next divided the empty Graafian vesicle by splitting the ovary with a bistoury, carrying the incision down through the middle of the open pore to the bottom of the cyst, which contained the usual clot of blood. The letter A in the figure is at the fundus uteri; the os is seen in the open vagina. At B is the left ovary; c is the trace of an incision made there through a scar left after a preceding ovulation; E is the right ovarium, and F points to the empty crimped cavity of the recently evacuated Graafian cell.

The internal surface of the cell was raised up into convolutions like those on the surface of a brain, an appearance always to be observed, and which depends on the filling up of the space between the outer coating and the inner coating of the ovicapsule. This insertion or impaction of substance betwixt the two coverings causes the inner coat to be crimped, folded, or convoluted as above mentioned, a process which probably tends to press the escaping egg towards the opening hila from whence it is at last, by this mechanism, quite expelled.

The late Dr. Joshua Wallace presented to me a few years since the womb and ovaries of a young woman who died suddenly while menstruating. The cavity of the womb contained a portion of the menstrual fluid. In that specimen I found the bloody pore or hila in the Graafian cell, which as usual contained a clot of blood. I need describe no others of the numerous specimens of the same kind that I have had in my hands; it suffices to say that no woman who dies while in the act of menstruating, fails to exhibit such vestigia to the dissector who seeks for them. Nevertheless, no one yet knows at what mo

ment the hila is prepared, and we have only to consider it probable that the uterine engorgement is coincident with that of the ovaries, and that, as soon as the ovicapsule becomes empty, the lessening of the ovaric tension allows the ovarian molimen to begin to lessen. It is, under all circumstances, most probable that the egg escapes very nearly at the time that the womb begins to bleed, and that the uterus continues to pour out its blood until its vascular congestion and nervous erethism are dissipated by the hemorrhagic discharge.

Writers of a late period have persisted in believing that the discharge of the ovum is due only to an act of impregnation or fecundation; but the modern Student of medicine knows that the germ could not be fecundated while locked up within the recesses of the ovisac, itself buried beneath the indusium and tunica albuginea of an ovarium. On the contrary, he knows that ovulation being a spontaneous act of ovipositing, fecundation of the egg can take effect only after it has been set at large by the act of the absorbents. Therefore, he also knows that a woman can be subject to fecundation only within some unknown but short season succeeding her menstruation. M. Pouchet, of Rouen, whose learned researches have thrown a flood of light on this before obscure department of physiology, seems to feel quite sure that the period after a menstruation during which the discharged ovule remains subject to fecundation, does not extend beyond the twelfth day, and I cannot gainsay that decision of the celebrated. naturalist and physician. I am, however, sure that it does extend to the eighth day, and probably beyond it, because Jewish women among my patients, and very prolific ones too, have assured me that they never did violate what they regard as a religious duty, that commands them to avoid the approach of their husbands until eight complete days have elapsed after the entire cessation of the mensual flux. They have assured me that in a very large Jewish sect this law is scrupulously fulfilled, and if so, we have in this religious custom a positive proof that the escaped egg remains apt for fecundation during the eight Jewish days of abstention. Why may it not also be true that M. Pouchet's law of twelve days is as correctly ascertained? There is surely no reason to suppose that the discharged ovule must necessarily perish or decay sooner than the twelfth day after its separation, since it may lie perdu within the fimbria or in the canal of the Fallopian oviduct, ready at any time to meet the conflict with the male zoosperm, which is fecundation.

However probable or even true it may be that a woman is unlikely to be fecundated later than the 12th day, it is by no means sure that she can safely indulge illicit passions under such an hypothesis,

because, while it is absolutely true that ovipositing is a periodical phenomenon repeated every twenty-eighth day, and accompanied with menstrual hemorrhage, it does not necessarily follow that a ripened germ may not, now and then, be cast off irregularly by a vigorous ovarium, without occasioning any hemorrhagic molimen and flowing. A woman, therefore, who believing that the period within which fecundation is possible has fairly gone by, and who consequently indulges in the sexual approach, may be caught and brought thereby to an open and palpable shame. I have been informed by more than one married woman, that her abstention, practising on the above principle, was of none effect.

The former doctrines of menstruation give us no clear indications of a therapeutical treatment of the disorders so frequently connected with that periodical act. It was foolishness to assign as a cause of the menstrual periodicity an influence of the moon, since observation and experience showed to all inquirers that there is no coincidence of the act with any particular phase of the moon, some women being always to be found just beginning, just concluding, or midway between the periods of monthly evacuation.

The doctrine of a general plethora, peculiar to the sex, and required of them as a means to the end of reproductiveness, was easily refuted by the always obvious facts of persons menstruating regularly even when very much reduced by sickness or other causes of oligæmia.

The true doctrine was that of a local plethora, or, in other words, a state of periodical hyperæmia of the reproductive organs; and now that doctrine is not only established, but it is made plain to the understanding, for the periodical paroxysm of stromatic force, that hurriedly concludes the ripening of the most perfect ova, establishes the affluxion that fills the capillaries of the reproductive organs, and engorges them, or renders them hyperæmic to the point of causing the monthly hemorrhage by which the hyperæmia is removed, leaving behind it no trace of indisposition.

This admirable exposition, for which we are so greatly indebted to its discoverers, preserves us from the most serious errors in our practice; while it reveals to us a vast deal of information as to the state and wants of women in whom the catamenia have become disordered, or in whom they have never appeared.

Heretofore, physicians have looked to the bloody sign alone as the act; hereafter, they will be likely to look upon the maturation and discharge of the ovarian ovule as the physiological act of menstruation,

and upon the sanguineous effusion only as the sign that the physiological act has been or is being performed.

True menstruation is the regular periodical evolution and expulsion of an ovule; it is ovulation. This act may suffice to cause the woman to bleed mensually, or it may prove insufficient to that end. It is, for the most part, a matter of indifference whether it does or does not cause the mensual hemorrhage; the essential thing is to mature and deposit the ovule. There are many circumstances of the menstruating girl or woman that are able to prevent her from bleeding, notwithstanding she may enjoy all the other faculties of perfect health.

As to the woman-a married woman who conceives in the womb does not necessarily upon that account cease to mature and deposit her germs. On the contrary, she retains a strong tendency to menstruate up to an advanced period of gestation. Yet she does not, as a very general rule, discharge the mensual fluid. But there are many examples of women who do actually retain, in the early months of pregnancy, the power to pour out from the vessels of the womb the usual product of menstruation; an act that must lead them to abortion.

Probably a woman has a much greater liability to abort at the time of her mensual crises than at any other time; which can only depend upon the occurrence of the catamenial effort under the periodical exacerbation of the germiferous force.

The same is true of the woman who gives suck.

A woman with a nursling at the breast does not, in general, menstruate until the child is seven months old; and thousands of women do not menstruate until they have weaned the child. Yet these women are liable to become pregnant; indeed, there are many who do become pregnant again and again before they have weaned their children, and before they have had the return. I say there are many such persons, so many, indeed, that the case is quite a familiar one to the accoucheur. A lady told me, on the 14th December, 1849, that she was pregnant again, and that she had not seen since the birth of the child which was born before the infant she was, at the above date, nursing, and which she must now wean before the due time of weaning. Such facts are proofs of the continuance of the germ-production in the ovary, as well as of the ovulation.

As to the young girl-a young female who has been brought up at home in the country, is rarely sent to a boarding-school to finish. her education without soon finding herself the subject of a catamenial derangement. She may have been perfectly regular at home; but, soon after she takes her place upon the school-form and daily devotes many

hours to study, the menses are apt to be suspended, and to remain suspended until she leaves the school, and ceases to consume her nerve-force in those mental or intellectual operations, that require for their effectuation all the biotic force she is capable of evolving. The consumption of this force leaves her destitute both of the power and the necessity to discharge the menstrual blood; not depriving her, however, of the force required to fulfil the true physiological office, the ripening, to wit, and the discharging of her monthly ovulum from the stroma. Her ovulation goes on regularly, and she is well, though not apparently menstruous. I have found many young wo men thus affected; but, the health being in all other regards perfect, I have not ventured to interfere beyond the interference of recommending a lessened devotion to mental labor, a more abundant and exciting diet, and a proper amount of daily exercise in the free air. Such amenorrhoeas cease as soon as the girl leaves school. Similar observations are to be met with in the writings of medical authors.

The pregnant and the suckling woman do not menstruate, because the life-force is fully occupied otherwise, yet they fulfil the germiferous law. In the same way, the studious and sedentary school-girl does not menstruate visibly, because her nervous mass is already preoccu pied. She performs, meanwhile, the physiological act of the ovi-ponte or ovulation, yet she does not bleed.

Let the woman miscarry, or wean, and she will soon perceive the visible sanguine sign of her ovi-ponte. Let the overtasked school-girl cease to call upon her nervous mass for impossible supplies of biotic force, and her menses will speedily return, and be regular in time and in sum; for her nervous energy is no longer misdirected, and improperly consumed in studies beyond its power of supply.

It is time to say a few words upon the catamenia, as connected with a computation of the commencement of pregnancy.

I presume that a woman cannot be fecundated except it be coinci dently with the ovi-posit. As a rule, then, a woman is liable to become pregnant only at, and about the periods of her monthly sickness; and, in computing the commencement of pregnancy, we shall commit the fewest errors if we begin the count at the day following that on which the flow ceased. Two hundred and eighty days should ▾ be allowed as the usual duration of a gestation.

One who is regular ought to see every twenty-eighth day. If she sees for three days only, then she ought to be twenty-five days without seeing.

In what portion of these twenty-five days is it that she is liable to impregnation? Dr. Pouchet insists that the liability extends to twelve