90 OF MENSTRUATION. 



prove it incontestably. Thus, in persons whose menses had been 

 long suppressed, in consequence of disease, or had never appeared, 

 in consequence of some faulty organisation of the vagina or vulva, 

 the womb has an hundred times been found full and distended with 

 blood ; in others who died while menstruating, the cavity of the 

 womb has been seen covered with ecchymoses, and sometimes filled 

 with clots of blood. If the os tincae be confined in the cupule of a 

 pessary with a cylindrical opening passing through it, the blood will 

 be found to escape therefrom: when there is a prolapsus, it may be 

 seen distilling from the cervix; and in the natural state, we find by 

 placing the finger between the lips of the os tincae, that the fluid 

 escapes from the part. 



222. On the other hand it is equally certain that it has sometimes 

 been seen to exude from the interior of the vagina or vulva; I do 

 not perceive, indeed, how it can be otherwise in a woman who con- 

 tinues to menstruate during her whole gestation. But these cases 

 are exceptions, anomalies, and do not invalidate the general rule : 

 menstruation is then deviated from its general route, as is the case 

 when it takes place from the urethra, the rectum, the pulmonary 

 passages, the breasts, or some portion of the tegumentary surfaces. 

 These irregularities, moreover, are rare, and appear to have been 

 in more than one instance the effect of real disease. 



223. Source. Attempts have been made, also, to ascertain the 

 immediate source of the menses, one party placing it in the veins, 

 alono- with Vesalius; in the arteries, with Ruysch; or the capillaries, 

 with Winslow and Meibomius; others think it is to be found in cer- 

 tain particular glandules, as Lister; or in peculiar little receptacles, 

 as Simson; or lastly, with Astruc, in a supposed set of venous sinu- 

 ses. There are as many gratuitous suppositions as there are opi- 

 nions, all of them referring to a question as idle as it is difficult of 

 solution. The menstrual blood escapes from the womb by exhala- 

 tion or by perspiration, as in all the lieraorrhagies of the mucous 

 membranes, but without our being able to learn whether it transudes 

 from the venous rather than from the arterial capillaries, and vice 

 versa. In this respect, whether the discharge be derived from the 

 body or cervix of the womb, from the vagina, or elsewhere, the me- 

 chanism of the function is always the same, and that is what it im- 

 ports us to know. 



224. Cessation. The age at which the menses cease to appear 

 is not less variable than that of their first eruption. Most generally 

 it is from forty-five to fifty years; but some women are exempted 

 at the age of forty, or even at thirty-six, thirty, twenty-six, or twen- 

 ty-four, as in the instances cited by Haller and others, and of which 



