days after the drying up of the discharge, and not beyond that time; and it seems probable that the ovule should retain its vitality without fecundation, so long as twelve days after its escape from the follicular pore.

If those Jewish women spoke truly, they gave incontrovertible evidence that the fallen ovule retains its fitness for impregnation, not only during the eight days subsequent to the drying up of the courses, but perhaps longer, since we know not precisely at what period of the mensual act the ovule departs from the cell. In the case already mentioned, of the young girl whose womb and ovaria were given to me by Dr. J. Wallace, the patient died while menstruating, and the uterus still contained a certain quantity of the menses; yet here the crypt was open, and the ovule had already escaped. It might, therefore, be fecundated as soon as the menses should disappear, but not before that disappearance.

In July, 1848, a young girl destroyed herself by taking arsenic, just before the expected return of the menses. Dr. Wistar, of this city, who examined the body, informs me that in one of the ovaries was a blood-red spot, the size of a lentil. There was no absolute rupture of the crypt as yet, nor any blood in the uterine cavity.

I repeat that we do not, as yet, know at what period of the mensual act the vesicle bursts. The above example proved to me that the rupture took place in the young girl, previous to the drying up of the discharge; so that, in the case of the Jewish women, if the same rule holds, we perceive that the ovule may be discharged, and yet retain its vitality without fecundation for eight days, and even more than eight days. But we do not know where it rests in such a case, from the period of its escape from the ovarian ovule, until it becomes fecundated eight days later.

After the foregoing, I am clearly not called upon to say at what precise period after the courses, a woman cannot possibly conceive. I have no doubt there is such a period. Time, and opportunity to observe, can alone settle this point. The celebrated case of the birth of Louis XIV., and the advice of the court physician, Fernel, relative thereto, ought not to be cited, since they have none of the characteristics of rigorous truth. It shows, however, the old date of opinions on this point. I am for the present very willing to believe, with M. Pouchet, that a woman shall not conceive later than the twelfth day, as a general law, though it may be that, occasionally, the fecundation may occur even later.

There are questions connected with this topic that ought not to be

lost sight of by the diligent Student, who desires to prepare himself upon all the points of a professional duty. For example

Some women are to be met with who never menstruate, and who yet preserve a most perfect physical and mental health.

Among these exceptional creatures are to be found those in whom the ovaria or the uterus has never been developed. Dr. Renauldin, on the 28th of Feb., 1826, reported to the Royal Academy of Medicine the case of a woman who died at the age of fifty-two years. She had never had any appearance of menstruation. The breasts were not developed. She had only a cervix uteri, which was of the size of a writing-quill-there was no womb proper-and the ovaries were scarcely developed.

Such a woman could not menstruate because of the double failure of uterus and ovary. There could be no sexual passion; indeed, such a creature was scarcely sexual.

When Percival Pott, the illustrious surgeon, removed the ovaria of his patient under an operation for hernia, he took away with them the power of menstruation. There are numerous examples of females who did never menstruate, owing to the absence of the ovaries. When our domestic animals are subjected to the operation of spaying, they are totally deprived of the power of ovulation; and with its loss the sexual sense disappears as well as the sexual attraction also; or if any remains are discernible, they are very imperfect.

As to the cases of absence of the womb, they are less rare than the former, and ought not to be lost sight of by the inquirer, lest he permit his ignorance to lead people into a grievous unhappiness. A woman ought not to be married who has never menstruated, until it shall have been clearly ascertained that she is not amenorrhoeal from faulty development.

I have seen several pretty women who were suffered to marry before it was ascertained that they had no wombs.

All attempts that were made, in either of these cases, to bring on menstruation, are well fitted to cast ridicule upon the physicians. A physician should never be otherwise than cautious in all his dealings with cases of absent or suspended menstruation. I state the following instance, in order to show the evil effects of a want of medical cautiousness.

Mrs. Blank, aged twenty-two and a half years, was married to her present husband more than two years ago. She is of a middling stature and fair complexion, and presents all the exterior appearances of a person in perfect health.

She is not fat, but has a certain embonpoint, a good figure, and a

very feminine and most agreeable expression of countenance. She is, indeed, a handsome woman.

She has never menstruated, nor has she suffered from catamenial pain, or severe attack of any disease. Seeing that she did not menstruate at the proper period, medical advice was sought and followed in the treatment of the case. The treatment was unsuccessful, and she was married with the expectation of her friends that the union. would be followed by an eruption of the catamenia. The mammæ were, at the period of the marriage, well developed, and the pudenda was amply supplied with hair; indeed, all the phenomena of a perfect development of the sexual system were present except those connected with the menstrual office.

The husband found, however, that some unknown cause acted as an impediment to the congress, and after more than two years of concealment, he consulted me on the subject.

An opportunity being allowed to me for a full investigation in presence of the mother, I found the external organs perfectly formed, the mons large, the labia and the nymphæ, as well as the clitoris, perfect, and the os magnum of a natural appearance; but the vagina was a mere cul-de-sac, not more than two inches, and probably less than that, in length. Upon pressing the point of the finger strongly against the bottom of the cul-de-sac, it seemed to have no connection with any vaginal part above it.

I requested the lady to lie on her back; and, introducing the index finger of the right hand as far as possible into the rectum, I explored with it the excavation of the pelvis, in order to discover any tumor or organ that might be contained within the cavity; but, as all the tis sues were ductile and very yielding, I began to suspect that there might be no womb at all in the case. Therefore, laying the fingers of the left hand upon the lowest part of the hypogaster, and pressing them firmly towards the finger that was used in exploring the internal parts, I found that they could be brought so near to each other as to make it perfectly clear that there was no womb in the case; otherwise, I must have felt it, so near was the approximation of the fingers of the right to those of the left hand.

Having, by the most careful exploration in this manner, discovered the unfortunate state of the young lady, I felt obliged, in a conscientious discharge of duty, to tell her the whole truth, which I did in the best way I could; and yet, as may be readily supposed, the knowledge of her situation was accompanied with all the manifestations of that violent distress and agitation which might naturally flow from such unhappy circumstances.

The aphrodisiac sense in this lady is very strong, which might well be the case where the ovaria are fully developed, even though the uterus had never been evolved in her constitution.

I was deeply impressed myself with the melancholy fate of two estimable persons, who would never have placed themselves in so unhappy a condition if, by a proper exploration of the parts before marriage, the real state of the case could have been discovered. The case also seems to show how improper it is to permit the rites of marriage to be solemnized for persons who do not possess all the attributes properly belonging to the sexes. I do not contend that every case of failure to menstruate at the proper season is indicative of the necessity for exploration by the touch; but I think no case of extraordinary protraction of an emansio mensium, and especially where any question of contract of marriage is likely to arise, should be allowed to go on without the acquirement, by a medical adviser, of true and perfect knowledge of the facts as to the organization of the parts.

In the early part of the year 1848, I met with another example of similar want of development in a comely young person, who had been married some three months before. A shallow vaginal culde-sac at the bottom of well-developed external genitalia, mammary glands of full size, warm aphrodisiac temperament, and abundant hair, showed that all the sexual physical attributes were present, save only as to the absence of the uterus, no trace of which could be detected by Dr. Pancoast, Professor of Anatomy, by Dr. Jewell, of Philadelphia, or by my own careful exploration. No doubts were left upon our minds of the complete failure of uterine development.

Sn St.,

CASE. December 24, 1852, I visited Mrs. aged 22, of a delicate form and stature, but healthy and vigorous. She had been married eighteen months, and had never yet menstruated, nor suffered from any catamenial disorder.

The external genitalia are fully developed, and covered with hair, though less abundantly than is seen in many women. The mammæ are well formed, and of rather full size; the nipples large, with very dark areas. The hypogastric region soft and yielding to the touch, as in the healthiest women. Pressing the integuments down to the plane of the strait, no tumor or unnatural resistance is found. The vagina is a thin, membranous cul-de-sac, an inch and a half in depth. I could not discover any central stylus of indurated tissue, as would have been discovered had there been atresia from cohesion of the vagi nal walls, whence I infer that the cul-de-sac stops at the bottom of the

cavity, which never has been any deeper than now. The sexual desire is strong, and attempts of coitus frequent.

I pressed the left index finger as far as I could reach into the rectum, and also a female silver catheter five inches into the bladder. Carrying the point of the catheter backwards until I could touch it with the finger in the rectum, I could ascertain whether she had a womb or no; she had no womb.

I saw a similar case of absence of the womb here on the 3d of January, 1833.

The persons interested in this unfortunate situation, though less sensitive than those mentioned above, were rendered unhappy by so grave a misalliance; probably the last consequences of it may be greatly to be deplored. How important, then, is it that medical attendants, the only persons who can be competent, should be always cautious and watchful as to these points of duty.

Not only on account of the risk of fatal mistakes of the kind above mentioned should we be ever attentive to the duty of making accurate diagnosis, but there are a great many other shoals and quicksands in the track of the young practitioner, who fills his sails with the prosperous and flattering winds of his earliest successes.

He would find himself under obedience to a good rule who should firmly resolve never to pronounce any opinion as to the catamenial disorder until he has taken measures to form a solid and inexpugnable judgment on the cases submitted to his decision.

The consultations relative to this class of diseases are very numerous for medical men engaged in business. Well, let it be a rule to suspect of pregnancy every married woman who complains of amenorrhoea. This, though so obviously proper, is a rule often lost sight of by the medical practitioner, whence it happens that we encounter now and then the ridiculous circumstance of reiterated and vain attempts made by medical men to bring on menstruation in married women, who prove in the end to be pregnant. I have met with many such instances.

Let every married woman who does not menstruate be, therefore, treated as if reasons exist for supposing her to be gravid. If, by the lapse of time, or by the occurrence of circumstances, a solid conviction can be attained that the patient is not gravid, she may be suffi ciently early subjected to treatment conformable to her wants.

In like manner, in young unmarried women failing to menstruate, yet exhibiting no other evidence of disordered health, there is always time enough to consider what may be requisite in the treatment. The more especially, if we may believe, which I consider undeniable, that