

THE TESTICLE AND THE OVARY 359 



Sherrington, 1 after transecting the spinal cord of a bitch in the 

 cervical region, and headwards of the connection between the 

 sympathetic system and the cord, observed that heat of normal 

 duration and character continued to recur in the animal so operated 

 upon. The case, described by Brachet, 2 of a woman suffering from 

 paraplegia in the lower part of the body and legs, but who conceived 

 and became pregnant, may also be cited. 



There are other facts which indicate that menstruation is not 

 caused by a nervous reflex set up by ovulation or by the pressure of 

 the growing follicles. Gynecologists have pointed out that in the 

 human subject ovulation and menstruation are not necessarily 

 associated, and Heape 3 has shown that the ovaries of menstruating 

 monkeys do not always contain follicles in a state approaching 

 ripeness. 



But whereas the evidence is clear that heat and menstruation are 

 not brought about by nervous reflexes arising from the ovary, it is 

 equally obvious that these processes are dependent upon some ovarian 

 influence. For, if the ovaries are removed, heat and menstruation no 

 longer take place. 



Some authors, however, have denied this, and cases have been 

 cited of the occurrence of menstruation after surgical ovariotomy. 

 For example, three cases have recently been described by Doran, 4 

 in each of which the two ovaries were believed to have been removed, 

 although menstruation recurred at irregular intervals after the 

 operation. Further cases have lately been reported by Blair Bell 5 

 and other writers. It seems probable that these exceptional cases 

 are to be explained on the supposition that the extirpation of 

 ovarian substance was not quite complete, and that the tissue 

 which remained behind underwent hypertrophy subsequently to 

 the operation. That this is the true interpretation is rendered the 

 more probable in view of the cases referred to by Gordon, 6 Doran, 7 

 Meredith, 8 and others, in which pregnancy occurred after the 

 supposed removal of both ovaries (see also p. 370). Doran 9 also 



1 Sherrington, The Integrative Action of the Nervom System, London, 1906. 



2 Brachet, Recherches, 2nd Edition, Paris, 1837. 



3 Heape, " The Menstruation and Ovulation of Macaeus rhesus," Phil. Trans., 

 B., vol. clxxxviii., 1897. 



4 Doran, " Sub-total Hysterectomy for Fibroids," Lancet, Part II., November 

 1905. 



5 Blair Bell, " Preliminary Note on a New Theory of Female Generative 

 Activity," Liverpool Medico-Chimrgical Journal, July 1906. 



6 Gordon, "Two Pregnancies following the Removal of both Tubes and 

 Ovaries," Trans. A'iner. Gyntec. Soc., vol. xxi., 1896. 



7 Doran, " Pregnancy after the Removal of both Ovaries," Joivr. Obstet. and 

 OyiKKff., vol. ii., 1902. 



8 Meredith, " Pregnancy after Removal of both Ovaries," Brit. Med. Jour., 

 Part I., 1904. 



9 Doran, " Sub-total Hysterectomy for Fibroids," Lancet, Part II., Nov. 1905. 



