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In a healthy girl the psychic and physical changes incident to puberty occur so gradually as to escape the girl's own notice. The first and, if the girl has not been properly prepared for it, always startling change is the appearance of the menstrual flow.

The presumptive signs are: menstrual suppression, morning sickness, irritable bladder, mental and emotional phenomena. The probable signs are: mammary changes, abdominal enlargement, changes in the neck of the womb, and certain changes which are felt on bimanual examination.

And so, since the menstrual flow ceases after about five days from its beginning, in about ten days after its stopping, the ovum will have passed out of the womb, and hence that organ contains nothing that is impregnable. Under these conditions, semen may be deposited in the womb, without danger of impregnation. This is a simple proposition, and easy to understand if once known.

What is the usual age for Chlorosis to occur and what are the symptoms? Chlorosis more frequently attacks girls from fifteen to twenty years of age; although unmarried women, much older, occasionally have it. I say unmarried, for, as a rule, it is a complaint of the single. The menstrual discharge is either suspended or very partially performed, if the latter, it is usually almost colourless.

And one day, after the menstrual period, the sister of Vasuki, having purified herself by a bath according to custom, approached her lord the great Muni; And thereupon she conceived. And the embryo was like unto a flame of fire, possessed of great energy, and resplendent as fire itself. And it grew like the moon in the bright fortnight.

Whenever patients pass their expected date uneventfully, if they will bear in mind that the fault lies with the method of prediction and not with the pregnancy, they will often be saved anxiety. Frequently such discrepancies are attributable to a false assumption, for our rule always assumes that the conception took place immediately after a menstrual period.

The mammae were large and painful, and the accompanying symptoms were those of ordinary menstruation. Boulger mentions an instance of periodic menstrual discharge from beneath the left mamma. Jacobson speaks of habitual menstruation by both breasts.

Forster speaks of a menstrual ulcer of the face, and Moses two of the head. White, quoted by Barnes, cites an instance of vicarious hemorrhage from five deep fissures of the lips in a girl of fourteen; the hemorrhage was periodical and could not be checked. At the advent of each menstrual period the lips became much congested, and the recently-healed menstrual scars burst open anew.

It is now known that the menstrual flow is not the whole of menstruation, and that the changes going on in the uterus are almost as continuous as the process of digestion. The whole of the reproductive life of woman has been divided into cycles of twenty-eight days each; these cycles have been divided into four stages. Stages of the Menstrual Cycle.

By the menopause or climacteric is understood the whole period from the beginning irregularities in the time of appearance of the menstrual flow until its actual cessation. The average duration of the menopause is from two and a half to three years. The Menopause. The menopause is a physiologic and conservative process.