379 



For the first three years the right ovarium was exclusively enlarged, 

 and the intervals were not so regularly marked, varying between three 

 and six weeks ; excepting for the first year, when they were much 

 longer, occasionally extending to three months. For the last two 

 years the left ovarium has been far more frequently affected, the 

 right remaining quiescent ; occasionally both are painful and tumid, 

 but even then one more than the other. The intervals are now pretty 

 regularly three weeks. The acute inflammatory symptoms which 

 accompanied the onset of these swellings have long since ceased to 

 recur, which is obviously due to the loose state of the tissues from 

 repeated stretching, so that the swollen organ is no longer compressed. 



The accession of a menstrual time is sometimes suddenly felt. She 

 will go to bed well, and in the morning the ovary will be swollen : 

 more commonly, however, it is very gradual, augmenting in volume 

 for four days, then remaining stationary for three days, and then gra- 

 dually declining ; the whole process, before the ovary is reduced, 

 generally lasting ten or twelve days. On separating the ovary, when 

 at its height of swelling, from the tissues surrounding it, it appears 

 scarcely, if at all, less than double its usual volume ; its outline is 

 clearly defined, and it is plain that the whole, and not merely a part, 

 of the organ is involved. There is no suffering worthy of notice 

 during the time : the swelling is tender if pressed ; and tender, too, 

 in the act of sitting down or rising up ; but she walks about as usual 

 without distress, and there is but little lumbar or hypogastric pain. 

 Neither are there any manifest sympathies excited, either of the 

 mammary glands or other organs. Nor is there any vicarious flux, 

 either of blood or any secretion, with the exception of an excess of 

 saliva, but this not in any large flow. The ovary alone appeared to 

 be engaged in this periodical act, which it is not too much to sup- 

 pose, in accordance with modern physiological views, would have 

 been attended with a flux of blood, had not the organs which nor- 

 mally supply it been absent. 



But while this may be said to represent the usual course of a 

 period, yet the volume of the ovary, and the length of time it remains 

 swollen, is subject to occasional variation ; sometimes being much less 

 tumid, and dying away in a shorter time. 



The repeated attempts at sexual union have only had the effect of 

 somewhat loosening the tissues around the vulva, but the vagina 



VOL. VIII. 2 G 



