UTERUS (FUNCTIONS). 



during the existence of the menstrual pheno- 

 mena, the blood was invariably found issuing 

 from diseased surfaces situated upon or about 

 the labia uteri, none escaping from the interior 

 of the organ."* 



But in any case there is wanting a sufficient 

 series of observations, taking cognisance of 

 the exact duration and times of recurrence of 

 such discharges, and comparing these with the 

 normal periods and intervals of menstruation, 

 to warrant an unhesitating belief in the occur- 

 rence of a true catamenial flow as a possible 

 phenomenon during gestation. 



Quantity. The quantity of the menstrual 

 fluid which escapes at each period has been 

 so variously estimated at different times and 

 by different observers, as to render it obvious 

 that the calculations could not have pro- 

 ceeded upon any common data. Thus Hip- 

 pocrates, and afterwards Galen who quotes 

 him, states the quantity as two Attic hemina, 

 equal to about eighteen ounces. In recent 

 times it has been estimated by Magendie at 

 several pounds, and Haller gives the average 

 amount as varying from six to twelve ounces. 

 But all these estimates are too high. Dehaen, 

 who employed an ingenious method of mea- 

 surement, calculated that some women lost 

 three, others five ounces, and very few half a 

 pound ; but that it was exceedingly rare for a 

 woman who had no malady to lose as much 

 as ten ounces.f Probably the only proceed- 

 ing by which any definite result can be ob- 

 tained, is that of observing the rate of escape 

 of the discharge from the uterine orifice. 

 According to the observations of Mr. White- 

 head, this is generally so slow that no more 

 than from ten to twelve grains could be pro- 

 cured during the time that the patient was 

 able to endure the irksomeness of the pro- 

 ceeding. From these, and similar observations 

 of my own, as well as from other estimates, I 

 conclude that two to three ounces is probably 

 the full extent of the natural flow, and that a 

 discharge amounting to six or more ounces in 

 the aggregate will generally produce for the 

 time sensible effects upon the constitution, 

 such as general pallor, and some feebleness of 

 the muscular system. 



Xature of the catamenial discharge. There 

 is no foundation for the belief once so preva- 

 lent, and even partially still retained, that the 

 menstrual fluid contains materials of a noxious 

 or poisonous nature, nor yet that it serves as 

 a vehicle for the depuration of the blood of 

 the female. The occasional fetid odour of 

 the discharge, and sometimes also of the 

 breath of women during menstruation, arises 

 from the decomposition of the fluid, as it 

 slowly collects in the vagina, and doubtless 

 also from its partial resorption into the system, 

 producing in such cases a heavy or foetid odour 

 of the breath, the cause of which was pointed 

 out more than two centuries ago by De Graaf. J 

 The menstrual fluid has always, even in health, 

 a peculiar and somewhat heavy odour which 



* Whitehead, loc. cit. p. 24. 



t Brierre de Boismont, op. cit. p. 68. 



J De Mul. Organ. Lag. Bat 1672, p. 134. 



663 



is as characteristic of it, as is the gravis odor 

 puerperii of the lochial and other discharges 

 in childbed.* But these circumstances afford 

 no evidence that the excretion is, when first 

 formed, necessarily unhealthy. 



The menstrual fluid, when first formed, ap- 

 pears to consist almost entirely of pure blood ; 

 but, in its course through the vagina, it re- 

 ceives in addition the secretions of that 

 canal, whereby both its physical condition and 

 chemical constitution are materially altered. 

 Hence the differences of opinion which have 

 so long prevailed regarding the real nature of 

 this fluid, and the extent to which it differs 

 from pure blood. These differences have been 

 maintained chiefly by the well-known fact that 

 menstrual blood seldom coagulates, and also 

 by the difficulty of discovering fibrine in it. 

 But a solution of this difficulty is found in the 

 fact that the mucus of the vagina has always 

 an acid reaction, and that in this acid the 

 fibrine of the blood is so readily dissolved, 

 that not only is its coagulation prevented, but 

 chemical analysis fails usually to reproduce 

 more than a trace of it. 



The menstrual fluid, therefore, as escaping 

 from the vaginal orifice, and that collected 

 from the os uteri, are essentially two different 

 products, and this distinction should be ob- 

 served in all examinations having reference to 

 its chemical or physical composition. But it 

 would be perhaps arbitrary to designate either 

 of these alone the menstrual fluid. Probably 

 this term is most suitable to the first. Both 

 the vagina and uterus are concerned in the 

 production of this fluid in the form in which 

 it is most familiarly known, and in this form 

 it may first be examined, the pure and un- 

 mixed* product of the uterus being reserved 

 for subsequent consideration. 



Composition of menstrual fluid according to Hf. Denis. 



Water - ... 82'50 



Fibrine ----- Q'05 



Hematosine - - - 6-34 



Mucus ----- 4-53 



Albumen - 4-83 



Oxide of iron - 0-05 



Osmazome and cruorine, of each - (Ml 



Salts and fatty matter - - 1*59 



Microscopic examination. The menstrual 

 flux exhibits three periods or stages ; viz. the 

 periods of invasion, stasis, and decline. In 

 the first the discharge is of a paler colour, 

 and sometimes consists mainly or entirely 

 of mucus menstrua alba. But this stage 

 is not always observed, the discharge often 

 commencing at once of the deep red colour 

 characteristic of the middle stage. This con- 

 tinues during the greater part of the period, 

 and is succeeded by the third stage or that of 



* Doubtless this led Pliny to draw up that dire 

 catalogue of evils, in which he informs us, that the 

 presence of a menstruating woman turns wine sour ; 

 causes trees to shed their fruit, parches up their 

 young shoots, and makes them for ever barren ; 

 dims the splendour of mirrors and the polish of 

 ivory ; turns the edge of sharpest iron ; converts 

 brass to rust ; and is a cause of canine rabies. C. 

 Plinii, Nat. Hist, liber vii. xiii. ed. Cuvier, 8vo. 

 vol. i. Paris, 1*27. 



V U 4 



