﻿442 
  Dr. 
  J. 
  Williams 
  on 
  the 
  Discharge 
  of 
  Ova, 
  and 
  [May 
  27, 
  

  

  menstrual 
  flow. 
  Both 
  ovaries 
  were 
  bound 
  to 
  the 
  surrounding 
  structures 
  

   by 
  tough 
  and 
  firm 
  false 
  membranes. 
  The 
  left 
  contained 
  a 
  follicle 
  nearly 
  

   an 
  inch 
  in 
  length, 
  in 
  which 
  was 
  found 
  a 
  sof 
  tish, 
  dark-coloured 
  clot, 
  having 
  

   a 
  spongy 
  texture, 
  which 
  appeared 
  to 
  be 
  several 
  clays 
  old. 
  

  

  In 
  the 
  first 
  and 
  third 
  members 
  of 
  this 
  group 
  haemorrhage 
  had 
  taken 
  

   place 
  into 
  the 
  follicle 
  unquestionably 
  before 
  the 
  appearance 
  of 
  the 
  cata- 
  

   menial 
  discharge. 
  

  

  In 
  the 
  second, 
  haemorrhage 
  had 
  occurred 
  before 
  the 
  flow 
  had 
  become 
  

   clue 
  ; 
  but 
  the 
  latter, 
  owing 
  to 
  surgical 
  interference, 
  having 
  returned 
  a 
  

   week 
  before 
  its 
  time, 
  the 
  haemorrhage 
  took 
  place 
  while 
  the 
  discharge 
  was 
  

   in 
  progress. 
  

  

  In 
  the 
  fourth, 
  the 
  condition 
  of 
  the 
  clot 
  makes 
  it 
  almost 
  certain 
  that 
  

   the 
  haemorrhage 
  had 
  taken 
  place 
  before 
  the 
  appearance 
  of 
  the 
  catamenia. 
  

  

  C. 
  One 
  case, 
  in 
  which 
  a 
  Graafian 
  follicle 
  had 
  matured, 
  but 
  where 
  neither 
  

   rupture 
  nor 
  haemorrhage 
  had 
  actually 
  occurred. 
  

  

  This 
  was 
  a 
  patient 
  who 
  died 
  of 
  typhoid 
  fever 
  just 
  before 
  the 
  appear- 
  

   ance 
  of 
  the 
  catamenia. 
  In 
  one 
  ovary 
  there 
  was 
  an 
  enlarged 
  Graafian 
  

   follicle, 
  which 
  was 
  highly 
  vascular, 
  and 
  projected 
  like 
  a 
  nipple 
  beyond 
  

   the 
  surrounding 
  surface. 
  It 
  was 
  evidently 
  on 
  the 
  point 
  of 
  bursting, 
  and 
  

   it 
  is 
  doubtful 
  whether 
  rupture 
  of 
  the 
  follicle 
  or 
  the 
  appearance 
  of 
  the 
  

   discharge 
  would 
  have 
  taken 
  place 
  first. 
  

  

  D. 
  Cases, 
  three 
  in 
  number, 
  in 
  which 
  no 
  Graafian 
  follicle 
  had 
  become 
  

   enlarged 
  to 
  the 
  size 
  exhibited 
  by 
  it 
  at 
  maturity. 
  

  

  The 
  first 
  was 
  a 
  patient 
  in 
  whom 
  the 
  menstrual 
  flow 
  had 
  almost 
  ceased. 
  

   There 
  was 
  no 
  rupture 
  in 
  either 
  ovary, 
  but 
  the 
  right 
  contained 
  a 
  Graafian 
  

   follicle 
  about 
  the 
  size 
  of 
  a 
  small 
  pea. 
  

  

  The 
  next 
  was 
  a 
  young 
  suicide, 
  who 
  died 
  three 
  days 
  after 
  the 
  cessation 
  

   of 
  the 
  catamenial 
  discharge. 
  There 
  was 
  no 
  recent 
  rupture 
  in 
  either 
  

   ovary, 
  but 
  the 
  left 
  contained 
  a 
  follicle 
  similar 
  to 
  the 
  one 
  seen 
  in 
  the 
  pre- 
  

   ceding 
  case. 
  

  

  The 
  last 
  member 
  of 
  the 
  series 
  was 
  a 
  girl 
  who 
  died 
  of 
  peritonitis, 
  

   caused 
  by 
  the 
  rupture 
  of 
  an 
  abscess 
  on 
  the 
  right 
  ovary. 
  In 
  the 
  left 
  was 
  

   a 
  Graafian 
  follicle 
  about 
  the 
  size 
  of 
  a 
  small 
  pea, 
  but 
  no 
  recent 
  rupture. 
  

   The 
  state 
  of 
  the 
  lining 
  membrane 
  of 
  the 
  uterus 
  showed 
  that 
  in 
  this 
  

   case 
  menstruation 
  was 
  imminent. 
  

  

  Besides 
  the 
  appearances 
  described, 
  there 
  were 
  in 
  all 
  the 
  preceding 
  

   cases 
  numerous 
  Graafian 
  follicles, 
  varying 
  in 
  size 
  from 
  a 
  millet-seed 
  

   downwards, 
  together 
  with 
  some 
  superficial 
  pits 
  and 
  atrophied 
  corpora 
  lutea. 
  

  

  These 
  cases 
  appear 
  to 
  me 
  to 
  bear 
  out 
  the 
  opinion 
  stated 
  at 
  the 
  begin- 
  

   ning 
  of 
  the 
  paper, 
  that, 
  in 
  the 
  great 
  majority 
  of 
  subjects, 
  the 
  discharge 
  of 
  

   ova 
  takes 
  place 
  before 
  the 
  appearance 
  of 
  the 
  menstrual 
  flow 
  with 
  which 
  

   it 
  is 
  connected 
  ; 
  for 
  in 
  ten 
  out 
  of 
  the 
  fourteen 
  rupture 
  of 
  a 
  follicle, 
  or 
  

   haemorrhage 
  into 
  its 
  cavity, 
  had 
  occurred 
  before 
  the 
  return 
  of 
  the 
  cata- 
  

   menia; 
  in 
  one 
  it 
  was 
  doubtful 
  whether 
  rupture 
  of 
  a 
  follicle, 
  or 
  the 
  

   appearance 
  of 
  the 
  discharge 
  would 
  have 
  taken 
  place 
  first 
  ; 
  in 
  two 
  a 
  

   menstrual 
  period 
  had 
  passed 
  without 
  maturation 
  of 
  a 
  follicle 
  ; 
  and 
  in 
  one 
  

  

  