MENSTRUATION". 571 



accompanied by some disturbance of the general system, and the 

 female is then known to have arrived at the period of puberty. 



Afterward, the bloody discharge just spoken of returns at regular 

 intervals of four weeks ; and, on account of this recurrence corres- 

 ponding with the passage of successive lunar months, its phenomena 

 are designated by the name of the "menses" or the "menstrual 

 periods." The menses return with regularity, from the time of 

 their first appearance, until the age of about forty- five years. 

 During this period, the female is capable of bearing children, and 

 sexual intercourse is liable to be followed by pregnancy. After 

 the forty-fifth year, the periods first become irregular, and then 

 cease altogether ; and their final disappearance is an indication that 

 the woman is no longer fertile, and that pregnancy cannot again 

 take place. 



Even during the period above referred to, from the age of fifteen 

 to forty-five, the regularity and completeness of the menstrual 

 periods indicate to a great extent the aptitude of individual females 

 for impregnation. It is well known that all those causes of ill 

 health which derange menstruation are apt at the same time to 

 interfere with pregnancy ; so that women whose menses are habi- 

 tually regular and natural are much more likely to become preg- 

 nant, after sexual intercourse, than those in whom the periods are 

 absent or irregular. 



If pregnancy happen to take place, however, at any time during 

 the child-bearing period, the menses are suspended during the con- 

 tinuance of gestation, and usually remain absent, after delivery, as 

 long as the woman continues to nurse her child. They then re- 

 commence, and subsequently continue to appear as before. 



The menstrual discharge consists of an abundant secretion of 

 mucus mingled with blood. When the expected period is about 

 to come on, the female is affected with a certain degree of discomfort 

 and lassitude, a sense of weight in the pelvis, and more or less dis- 

 inclination to society. These symptoms are in some instances 

 slightly pronounced, in others more troublesome. An unusual 

 discharge of vaginal mucus then begins to take place, which soon 

 becomes yellowish or rusty brown in color, from the admixture of 

 a certain proportion of blood ; and by the second or third day the 

 discharge has the appearance of nearly pure blood. The unpleasant 

 sensations which were at first manifest then usually subside; and 

 the discharge, after continuing for a certain period, begins to grow 

 .more scanty. Its color changes from a pure red to a brownish or 



