v GENEEATIVE SYSTEM OF THE FEMALE 179 



Hebrews, not to practise coitus until twelve days from the 

 beginning of menstruation. 



III. Modern obstetricians and gynaecologists consider that 

 ovulation coincides with the period of pre-menstrual tumefaction, 

 when there is an increase of general functional tone, and a more 

 accentuated tendency to sexual intercourse. Several times during 

 the examination of women accidentally killed, or operated on 

 during the menstrual period, there has been observed in one or 

 other of the ovaries a recently ruptured Graafian follicle. I 

 myself remember having as a student met with such an instance 

 in the body of a young woman at the clinic of Concato. In some 

 women in whom an adequate examination of the ovary is possible, 

 the obstetrician can some days before the beginning of menstrua- 

 tion recognise by digital manipulation a projection in the right 

 or left ovary, of the size of a cherry and painful to pressure ; 

 this is certainly due to a mature follicle, ready to burst, for it 

 disappears with menstruation. 



According to Strassmann, a latent period of one or two days 

 intervenes between the rupture of the mature follicle and men- 

 struation. This time-relation between the esca'pe of the ovum 

 and the beginning of the menstrual flow leads one to admit a 

 causal connection between the phenomena. A series of facts 

 demonstrate that the ovary is the predominant organ, from which 

 start the impulses to all the periodic functions of the female 

 genital apparatus, and to all the modifications of functional tone 

 of the whole organism which accompany them. On the other 

 hand, the functions of the ovary are independent of these local 

 and general effects which they bring about, but which may also 

 be wanting, as is demonstrated by the following facts. 



(a) Although ovulation is followed normally by menstruation, 

 there are physiological states (lactation) and pathological 

 (oligaemia) in which ovulation occurs without being followed by 

 any menstrual flow (amenorrhoea). 



(6) For the occurrence of menstruation it is not absolutely 

 necessary that there should be rupture of a Graafian follicle ; it 

 is sufficient that an ovum in the process of maturation, and 

 before it has arrived at complete development, should perish by 

 chromatolysis of the germinal vesicle in the interior of the follicle ; 

 this may happen through abnormal increase of the abdominal 

 pressure around the ovary, however caused, which is capable of 

 preventing the bursting of the follicle (Strassmann). This fact 

 being admitted, we can easily account for the exceptional cases 

 observed by Kolliker, Coste, Leuckhart, and Eitsche of women in 

 whom during abdominal section during the menstrual period 

 no recent corpus luteum was seen, although closed follicles 

 in the process of maturation, atrophy, or degeneration were 

 observed. 



