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In amenorrhea the menstrual flow may not appear for some years after it is normally due; or the flow may cease after some months or years of continuance; or the flow may be abnormally scanty or even absent.
Consideration of these facts renders apparent the impossibility of fixing with certainty the date of the beginning of pregnancy, since conception may result from the union of the ovum liberated at the beginning of the period with the spermatozoon introduced at the end of that time; or it may result from the meeting of the male elements already within the oviduct with an ovum discharged a day or two before the occurrence of the menstrual period.
Tilt's cases showed that women who suffered much at the menopause had previously suffered at puberty and at the menstrual periods. And among thirty-nine cases where there was no suffering at the menopause, there was the same immunity from suffering at puberty and at the menstrual epochs. Tilt's statistics were, or course, taken from English women.
A peculiar mode is vicarious menstrual hemorrhage through old ulcers, wounds, or cicatrices, and many examples are on record, a few of which will be described. Calder gives an excellent account of menstruation at an ankle-ulcer, and Brincken says he has seen periodical bleeding from the cicatrix of a leprous ulcer.
I think not; you have blighted her confidence and alienated her affections. You have kept knowledge from her that she had a right to know; you even failed to teach her the important truths of menstruation. Troubled and excited at the first menstrual flow, she dashed her feet in cold water hoping to stop the flow. You know the results she is now twenty-five but is suffering from it to this day.
Race does unquestionably influence the duration, but given a sound healthy race, which is not too much enervated with civilization, and the menstrual process will, equally with the total physical vigor and the vitality, be increased.
What seems to happen in fact, is this: the corpus luteum secretion stimulates the dormant cells of the mammary glands, formed during puberty, but latent until the advent of pregnancy. We know that injection of corpus luteum will cause an hypertrophy of the breasts. The same effect is produced regularly during the menstrual period, with a consciousness of swelling of the breasts.
The fact that the cavity of the uterus has been deprived of its lining is responsible for the lochia, whereas the menstrual discharge occurs in spite of the lining, through which it breaks at regular intervals in response to a stimulus that is absent for a longer or shorter period after the birth of a child.
At the cessation of the menstrual flow, she generally had a supplementary epistaxis, and on one occasion, when this was omitted, she suffered a sudden effusion into the anterior chamber of the eye. The discharge had only lasted two hours on this occasion. He also relates an example of hemorrhage into the vitreous humor in a case of amenorrhea.
The deficiencies were remedied by operation. Berard mentions a similar deformity and operation in a girl of eighteen. Gooding cites an instance of absent vagina in a married woman, the uterus discharging the functions. Gosselin reports a case in which a voluminous tumor was formed by the retained menstrual fluid in a woman without a vagina.
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