894 OP GENERATION ACTION OF THE FEMALE. 



conception often takes place immediately before the last appearance of the 

 catamenia (and not after it, as commonly imagined), is one well known to 

 practical men. Numerous cases have been collected by Mr. Gird wood, Dr. 

 Robert Lee, MM. Geudrin, Negrier, Raciborski, and others, in which the 

 menstrual period was evidently connected with the maturation and dis- 

 charge of ova ; x but the most complete observations yet made on this sub- 

 ject, are those of Dr. Ritchie (loc. cit.). He states that about the period of 

 puberty a marked change usually takes place in the mode in which the ovi- 

 sacs discharge their contents ; but that this change does not necessarily occur 

 simultaneously with the first appearance of the catamenia ; as in some cases 

 the conditions which obtain in the period before puberty, are extended into 

 that of menstruation. The ovaries now receive a much larger supply of 

 blood; the ovisacs show a great increase in bulk and vascularity, so that, 

 when they appear at the surface of the ovary, they present themselves as 

 pisiform turgid elevations ; and the discharge of their contents leaves a 

 much larger cicatrix, and is accompanied by an effusion of blood into their 

 cavity, with other subsequent changes to be presently described. It would 

 appear, however, that although such a discharge takes place most frequently 

 at the menstrual period, yet the two occurrences are not necessarily co- 

 existent; for menstruation may take place without any such rupture; whilst, 

 on the other hand, the maturation and discharge of mature ova may occur 

 in the intervals of menstruation, and even at periods of life when that func- 

 tion is not taking place. Perhaps the most correct general statement 

 on the subject would be this : that there is a periodic return of Ovarian 

 excitement, which tends to the maturation and extrusion of ovules, though 

 it may not always reach that point ; whilst there is also a periodic turges- 

 cence of the vessels of the lining membrane of the Uterus, which tends to 

 the production of a decidual membrane; but that these two periods, though 

 usually coincident, are not necessarily so ; and that either change may occur 

 without the concurrence of the other. 



742. The duration of the period of aptitude for procreation, as marked 

 by the persistence of the Catamenia, is more limited in Women than in 

 Men, usually terminating at about the 45th year; it is sometimes prolonged, 

 however, for ten or even fifteen years further; but cases are rare in which 

 \vomen above 50 years of age have borne children. 2 There is usually no 

 menstrual flow during pregnancy and lactation; in fact, the cessation of the 

 catamenia is generally one of the first signs indicating that conception has 

 taken place. But it is by no means uncommon for them to appear once or 

 twice subsequently to conception ; and in some women there is a regular 

 monthly discharge, though probably not of the usual character, through the 

 whole period. Some very anomalous cases are on record, in which the cata- 

 menia never appeared at any other time than during pregnancy, and were 

 then regular. The absence of the catameuia during lactation is by no means 

 constant, especially if the period be prolonged ; when the menstrual discharge 

 occurs, it may be considered as indicating an aptitude for conception ; and 



1 Such at least appears to bo the legitimate inference from the state of the Ovaries; 

 but the cases are very few in which the extruded Ova have been found in tin- female 

 passages. Two such cases (one of them, however, not altogether satisfactory) were 

 recorded by Dr. Letheby, in Philos. Transact., 1852. 



' I>r. Matthews Duncan has clearly shown (Trans. Roy. Soc. of Edin., vol. xxiii, 

 p. Mis | that the total fertility of fertile women diminishes as the age at which mar- 

 riage takes place increases. Sterility is rare amongst those marrying between the 

 ages of 20 and 24, but about 7 per cent, of those marrying between 15 and 20 are 

 sterile. These last, however, where fertile, bear more children than those marrying 

 at a later date. 



