HYDATIFORM DEGENERATION IN UTERINE PREGNANCY. 229 



the actual average age when considering general social statistics, then everyone 

 will admit that still less allowance than this need be made in the case of women who 

 are speaking to their physicians, knowing that whatever they may say will be 

 regarded as strictly confidential. That it is unnecessary to make large allowances 

 for understatement of their age on the part of these women is indicated also by 

 the average duration of their married life before aborting moles. This in the case 

 of 29 women was 7.1 years. Hence, if one bears in mind that the average age of 

 first marriages, according to Webb (1911), is 25.1 years, one easily can see that the 

 average age of the women aborting hydatiform moles, which was given as 29.6 

 years, probably is not too low at all, thus confirming the findings of Williamson, 

 who denied that hydatiform mole was especially common near the menopause. 



The conclusion that the average age of 29.6 years undoubtedly is near the 

 actual is confirmed also by the fact that a hydatiform mole was the first abortion 

 in 19 out of 41 women, or almost half the number; 12, or almost one-third, had 

 aborted twice; and only 10 had aborted more than twice. But what is still more 

 confirmatory is the existence of a surprising parallelism between the data on abor- 

 tion and those on births; 9 of 33 women had given birth to but 1 child, and an equal 

 number had given birth to but 2. Hence over 50 per cent of the 33 women had 

 borne children twice, or less than twice, and only 15, or less than half, had borne 

 oftener than this. 



This undoubted evidence of the youth of these women is confirmed still further 

 by the statement of Lewis and Lewis, who, from an analysis of 16,325 first births, 

 found that nearly one-half of them occur between the ages of 20 and 24, and 

 almost three-fourths between 20 and 29 years, although first births are more 

 frequent between 30 and 40 than between 15 and 19 years. I realize that social 

 statistics can not be translated from one country to another without modification, 

 but in such a mixed population as ours this modification probably need be less, 

 rather than greater, than in case of some countries. 



The conclusion that the occurrence of but a single birth before the advent of 

 hydatiform degeneration probably implies that such women are relatively young 

 is emphasized still further by the statement of Lewis and Lewis that in one-third 

 of the marriages in Scotland "the bride had a child when unmarried or was preg- 

 nant at the time of marriage," and that 50 per cent of the first births in Scotland 

 occur within 9 to 24 months after marriage. Lewis and Lewis also give the 

 average interval between marriage and the first birth in 16,176 cases as 13.54 

 months, but little more than one year. Since Lewis and Lewis stated that the 

 interval between the birth of the first and that of the second child is but little longer 

 than that between marriage and the birth of the first child, being only 3.07 years, it 

 is evident that not even those women who had borne two children before the advent 

 of hydatiform degeneration could have been near the menopause. This conclusion 

 is emphasized still further by the fact that in 96.12 per cent of 16,176 fruitful 

 marriages fertility was demonstrated within three years after marriage. 



Nevertheless, in spite of the clear implication of all these facts, I wish to 

 emphasize again that since what have been heretofore regarded as hydatiform 



