Following a miscarriage.
Hemorrhage from the mouth of a vicarious nature has been frequently
observed associated with menstrual disorders. The Ephemerides,
Meibomius, and Rhodius mention instances. The case of Meibomius was
that of an infant, and the case mentioned by Rhodius was associated
with hemorrhages from the lungs, umbilicus, thigh, and tooth-cavity.
Allport reports the history of a case in which there was recession of
the gingival margins and alveolar processes, the consequence of
amenorrhea. Caso has an instance of menstruation from the gums, and
there is on record the description of a woman, aged thirty-two, who had
bleeding from the throat preceding menstruation; later the menstruation
ceased to be regular, and four years previously, after an unfortunate
and violent connection, the menses ceased, and the woman soon developed
hemorrhoids and hemoptysis. Henry speaks of a woman who menstruated
from the mouth; at the necropsy 207 stones were found in the
gall-bladder. Krishaber speaks of a case of lingual menstruation at the
epoch of menstruation.
Descriptions of menstruation from the extremities are quite numerous.
Pechlin offers an example from the foot; Boerhaave from the skin of the
hand; Ephemerides from the knee; Albertus from the foot; Zacutus
Lusitanus from the left thumb; Bartholinus a curious instance from the
hand; and the Ephemerides another during pregnancy from the ankle.
Post speaks of a very peculiar case of edema of the arm alternating
with the menstrual discharge. Sennert writes of menstruation from the
groin associated with hemorrhage from the umbilicus and gums. Moses
offers an example of hemorrhage from the umbilicus, doubtless
vicarious. Verduc details the history of two cases from the top of the
head, and Kerokring cites three similar instances, one of which was
associated with hemorrhage from the hand.
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. In the Lancet is an account of a case
in the Vienna Hospital of simulated stigmata; the scar opened each
month and a menstrual flow proceeded therefrom; but by placing a
plaster-of-Paris bandage about the wound, sealing it so that tampering
with the wound could be easily detected, healing soon ensued, and the
imposture was thus exposed. Such would likely be the result of the
investigation of most cases of "bleeding wounds" which are exhibited to
the ignorant and superstitious for religious purposes.
Hogg publishes a report describing a young lady who injured her leg
with the broken steel of her crinoline. The wound healed nicely, but
always burst out afresh the day preceding the regular period. 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.
Knaggs relates an interesting account of a sequel to an operation for
ovarian disease. Following the operation, there was a regular, painless
menstruation every month, at which time the lower part of the wound
re-opened, and blood issued forth during the three days of the
catamenia. McGraw illustrates vicarious menstruation by an example, the
discharge issuing from an ovariotomy-scar, and Hooper cites an instance
in which the vicarious function was performed by a sloughing ulcer.
Buchanan and Simpson describe "amenorrheal ulcers." Dupuytren speaks of
denudation of the skin from a burn, with the subsequent development of
vicarious catamenia from the seat of the injury.
There are cases on record in which the menstruation occurs by the
rectum or the urinary tract. Barbee illustrates this by a case in which
cholera morbus occurred monthly in lieu of the regular menstrual
discharge. Barrett speaks of a case of vicarious menstruation by the
rectum. Astbury says he has seen a case of menstruation by the
hemorrhoidal vessels, and instances of relief from plethora by
vicarious menstruation in this manner are quite common. Rosenbladt
cites an instance of menstruation by the bladder, and Salmuth speaks of
a pregnant woman who had her monthly flow by the urinary tract. Ford
illustrates this anomaly by the case of a woman of thirty-two, who
began normal menstruation at fourteen; for quite a period she had
vicarious menstruation from the urinary tract, which ceased after the
birth of her last child. The coexistence of a floating kidney in this
case may have been responsible for this hemorrhage, and in reading
reports of so-called menstruation due consideration must be given to
the existence of any other than menstrual derangement before we can
accept the cases as true vicarious hemorrhage. Tarnier cites an
instance of a girl without a uterus, in whom menstruation proceeded
from the vagina. Zacutus Lusitanus relates the history of a case of
uterine occlusion, with the flow from the lips of the cervix. There is
mentioned an instance of menstruation from the labia.
The occurrence of menstruation after removal of the uterus or ovaries
is frequently reported. Storer, Clay, Tait, and the British and Foreign
Medico-Chirurgical Review report cases in which menstruation took place
with neither uterus nor ovary. Doubtless many authentic instances like
the preceding could be found to-day. Menstruation after hysterectomy
and ovariotomy has been attributed to the incomplete removal of the
organs in question, yet upon postmortem examination of some cases no
vestige of the functional organs in question has been found.
Hematemesis is a means of anomalous menstruation, and several instances
are recorded. Marcellus Donatus and Benivenius exemplify this with
cases. Instances of vicarious and compensatory epistaxis and hemoptysis
are so common that any examples would be superfluous. There is recorded
an inexplicable case of menstruation from the region of the sternum,
and among the curious anomalies of menstruation must be mentioned that
reported by Parvin seen in a woman, who, at the menstrual epoch,
suffered hemoptysis and oozing of blood from the lips and tongue.
Occasionally there was a substitution of a great swelling of the
tongue, rendering mastication and articulation very difficult for four
or five days. Parvin gives portraits showing the venous congestion and
discoloration of the lips.
Instances of migratory menstruation, the flow moving periodically from
the ordinary passage to the breasts and mammae, are found in the older
writers. Salmuth speaks of a woman on whose hands appeared spots
immediately before the establishment of the menses. Cases of
semimonthly menstruation and many similar anomalies of periodicity are
spoken of.
The Ephemerides contains an instance of the simulation of menstruation
after death, and Testa speaks of menstruation lasting through a long
sleep. Instances of black menstruation are to be found, described in
full, in the Ephemerides, by Paullini and by Schurig, and in some of
the later works; it is possible that an excess of iron, administered
for some menstrual disorder, may cause such an alteration in the color
of the menstrual fluid.
Suppression of menstruation is brought about in many peculiar ways, and
sometimes by the slightest of causes, some authentic instances being so
strange as to seem mythical. Through the Ephemerides we constantly read
of such causes as contact with a corpse, the sight of a serpent or
mouse, the sight of monsters, etc. Lightning stroke and curious
neuroses have been reported as causes. Many of the older books on
obstetric subjects are full of such instances, and modern illustrations
are constantly reported.
Menstruation in Man.--Periodic discharges of blood in man, constituting
what is called "male menstruation," have been frequently noticed and
are particularly interesting when the discharge is from the penis or
urethra, furnishing a striking analogy to the female function of
menstruation. The older authors quoted several such instances, and
Mehliss says that in the ancient days certain writers remarked that
catamenial lustration from the penis was inflicted on the Jews as a
divine punishment. Bartholinus mentions a case in a youth; the
Ephemerides several instances; Zacutus Lusitanus, Salmuth, Hngedorn,
Fabricius Hildanus, Vesalius, Mead, and Acta Eruditorum all mention
instances. Forel saw menstruation in a man. Gloninger tells of a man of
thirty-six, who, since the age of seventeen years and five months, had
had lunar manifestations of menstruation. Each attack was accompanied
by pains in the back and hypogastric region, febrile disturbance, and a
sanguineous discharge from the urethra, which resembled in color,
consistency, etc., the menstrual flux. King relates that while
attending a course of medical lectures at the University of Louisiana
he formed the acquaintance of a young student who possessed the normal
male generative organs, but in whom the simulated function of
menstruation was periodically performed. The cause was inexplicable,
and the unfortunate victim was the subject of deep chagrin, and was
afflicted with melancholia. He had menstruated for three years in this
manner: a fluid exuded from the sebaceous glands of the deep fossa
behind the corona glandis; this fluid was of the same appearance as the
menstrual flux. The quantity was from one to two ounces, and the
discharge lasted from three to six days. At this time the student was
twenty-two years of age, of a lymphatic temperament, not particularly
lustful, and was never the victim of any venereal disease. The author
gives no account of the after-life of this man, his whereabouts being,
unfortunately, unknown or omitted.
Vicarious Menstruation in the Male.--This simulation of menstruation by
the male assumes a vicarious nature as well as in the female. Van
Swieten, quoting from Benivenius, relates a case of a man who once a
month sweated great quantities of blood from his right flank. Pinel
mentions a case of a captain in the army (M. Regis), who was wounded by
a bullet in the body and who afterward had a monthly discharge from the
urethra. Pinel calls attention particularly to the analogy in this case
by mentioning that if the captain were exposed to fatigue, privation,
cold, etc., he exhibited the ordinary symptoms of amenorrhea or
suppression. Fournier speaks of a man over thirty years old, who had
been the subject of a menstrual evacuation since puberty, or shortly
after his first sexual intercourse. He would experience pains of the
premenstrual type, about twenty-four hours before the appearance of the
flow, which subsided when the menstruation began. He was of an
intensely voluptuous nature, and constantly gave himself up to sexual
excesses. The flow was abundant on the first day, diminished on the
second, and ceased on the third. Halliburton, Jouilleton, and Rayman
also record male menstruation.
Cases of menstruation during pregnancy and lactation are not rare. It
is not uncommon to find pregnancy, lactation, and menstruation
coexisting. No careful obstetrician will deny pregnancy solely on the
regular occurrence of the menstrual periods, any more than he would
make the diagnosis of pregnancy from the fact of the suppression of
menses. Blake reports an instance of catamenia and mammary secretion
during pregnancy. Denaux de Breyne mentions a similar case. The child
was born by a face-presentation. De Saint-Moulin cites an instance of
the persistence of menstruation during pregnancy in a woman of
twenty-four, who had never been regular; the child was born at term.
Gelly speaks of a case in which menstruation continued until the third
month of pregnancy, when abortion occurred. Post, in describing the
birth of a two-pound child, mentions that menstruation had persisted
during the mother's pregnancy. Rousset reports a peculiar case in which
menstruation appeared during the last four months of pregnancy.
There are some cases on record of child-bearing after the menopause,
as, for instance, that of Pearson, of a woman who had given birth to
nine children up to September, 1836; after this the menses appeared
only slightly until July, 1838, when they ceased entirely. A year and a
half after this she was delivered of her tenth child. Other cases,
somewhat similar, will be found under the discussion of late conception.
Precocious menstruation is seen from birth to nine or ten years. Of
course, menstruation before the third or fourth year is extremely rare,
most of the cases reported before this age being merely accidental
sanguineous discharges from the genitals, not regularly periodical, and
not true catamenia. However, there are many authentic cases of
infantile menstruation on record, which were generally associated with
precocious development in other parts as well. Billard says that the
source of infantile menstruation is the lining membrane of the uterus;
but Camerer explains it as due to ligature of the umbilical cord before
the circulation in the pulmonary vessels is thoroughly established. In
the consideration of this subject, we must bear in mind the influence
of climate and locality on the time of the appearance of menstruation.
In the southern countries, girls arrive at maturity at an earlier age
than their sisters of the north. Medical reports from India show early
puberty of the females of that country. Campbell remarks that girls
attain the age of puberty at twelve in Siam, while, on the contrary,
some observers report the fact that menstruation does not appear in the
Esquimaux women until the age of twenty-three, and then is very scanty,
and is only present in the summer months.
Cases of menstruation commencing within a few days after birth and
exhibiting periodical recurrence are spoken of by Penada, Neues
Hannoverisehes Magazin, Drummond, Buxtorf, Arnold, The Lancet, and the
British Medical Journal.
Cecil relates an instance of menstruation on the sixth day, continuing
for five days, in which six or eight drams of blood were lost. Peeples
cites an instance in Texas in an infant at the age of five days, which
was associated with a remarkable development of the genital organs and
breasts. Van Swieten offers an example at the first month; the British
Medical Journal at the second month; Conarmond at the third month.
Ysabel, a young slave girl belonging to Don Carlos Pedro of Havana,
began to menstruate soon after birth, and at the first year was regular
in this function. At birth her mamma were well developed and her
axillae were slightly covered with hair. At the age of thirty-two
months she was three feet ten inches tall, and her genitals and mammae
resembled those of a girl of thirteen. Her voice was grave and
sonorous; her moral inclinations were not known. Deever records an
instance of a child two years and seven months old who, with the
exception of three months only, had menstruated regularly since the
fourth month. Harle speaks of a child, the youngest of three girls, who
had a bloody discharge at the age of five months which lasted three
days and recurred every month until the child was weaned at the tenth
month. At the eleventh month it returned and continued periodically
until death, occasioned by diarrhea at the fourteenth month. The
necropsy showed a uterus 1 5/8 inches long, the lips of which were
congested; the left ovary was twice the size of the right, but
displayed nothing strikingly abnormal. Baillot and the British Medical
Journal cite instances of menstruation at the fourth month. A case is
on record of an infant who menstruated at the age of six months, and
whose menses returned on the twenty-eighth day exactly. Clark, Wall,
and the Lancet give descriptions of cases at the ninth month. Naegele
has seen a case at the eighteenth month, and Schmidt and Colly in the
second year. Another case is that of a child, nineteen months old,
whose breasts and external genitals were fully developed, although the
child had shown no sexual desire, and did not exceed other children of
the same age in intellectual development. This prodigy was
symmetrically formed and of pleasant appearance. Warner speaks of
Sophie Gantz, of Jewish parentage, born in Cincinnati, July 27, 1865,
whose menses began at the twenty-third month and had continued
regularly up to the time of reporting. At the age of three years and
six months she was 38 inches tall, 38 pounds in weight, and her girth
at the hip was 33 1/2 inches. The pelvis was broad and well shaped, and
measured 10 1/2 inches from the anterior surface of the spinous process
of one ilium to that of the other, being a little more than the
standard pelvis of Churchill, and, in consequence of this pelvic
development, her legs were bowed. The mammae and labia had all the
appearance of established puberty, and the pubes and axillae were
covered with hair. She was lady-like and maidenly in her demeanor,
without unnatural constraint or effrontery. A case somewhat similar,
though the patient had the appearance of a little old woman, was a
child of three whose breasts were as well developed as in a girl of
twenty, and whose sexual organs resembled those of a girl at puberty.
She had menstruated regularly since the age of two years. Woodruff
describes a child who began to menstruate at two years of age and
continued regularly thereafter. At the age of six years she was still
menstruating, and exhibited beginning signs of puberty. She was 118 cm.
tall, her breasts were developed, and she had hair on the mons veneris.
Van der Veer mentions an infant who began menstruating at the early age
of four months and had continued regularly for over two years. She had
the features and development of a child ten or twelve years old. The
external labia and the vulva in all its parts were well formed, and the
mons veneris was covered with a full growth of hair. Sir Astley Cooper,
Mandelshof, the Ephemerides, Rause, Geoffroy-Saint-Hilaire, and several
others a report instances of menstruation occurring at three years of
age. Le Beau describes an infant prodigy who was born with the mammae
well formed and as much hair on the mons veneris as a girl of thirteen
or fourteen. She menstruated at three and continued to do so
regularly, the flow lasting four days and being copious. At the age of
four years and five months she was 42 1/2 inches tall; her features
were regular, the complexion rosy, the hair chestnut, the eyes
blue-gray, her mamma the size of a large orange, and indications that
she would be able to bear children at the age of eight. Prideaux cites
a case at five, and Gaugirau Casals, a doctor of Agde, has seen a girl
of six years who suffered abdominal colic, hemorrhage from the nose,
migraine, and neuralgia, all periodically, which, with the association
of pruritus of the genitals and engorged mammae, led him to suspect
amenorrhea. He ordered baths, and shortly the menstruation appeared and
became regular thereafter. Brierre de Boismont records cases of
catamenia at five, seven, and eight years; and Skene mentions a girl
who menstruated at ten years and five months. She was in the lowest
grade of society, living with a drunken father in a tenement house, and
was of wretched physical constitution, quite ignorant, and of low moral
character, as evinced by her specific vaginitis. Occurring from nine
years to the ordinary time of puberty, many cases are recorded.
Instances of protracted menstruation are, as a rule, reliable, the
individuals themselves being cognizant of the nature of true
menstruation, and themselves furnishing the requisite information as to
the nature and periodicity of the discharge in question. Such cases
range even past the century-mark. Many elaborate statistics on this
subject have been gathered by men of ability. Dr. Meyer of Berlin
quotes the following:--
28 at 50 years of age,
3 at 57 years of age,
18 " 51 " " "
3 " 58 " " "
18 " 52 " " "
1 " 59 " " "
11 " 53 " " "
4 " 60 " " "
13 " 54 " " "
4 " 62 " " "
5 " 55 " " "
3 " 63 " " "
4 " 56 " " "
These statistics were from examination of 6000 cases of menstruating
women. The last seven were found to be in women in the highest class of
society.
Mehliss has made the following collection of statistics of a somewhat
similar nature--
Late Dentition. Late Late
Male. Female. Lactation. Menstruation.
Between 40 and 50 0 4 0 0
" 50 " 60 1 4 2 1
" 60 " 70 3 2 1 0
" 70 " 80 3 2 0 7
" 80 " 90 6 2 0 0
" 90 " 100 1 1 0 1
Above 100 ..... 6 1 0 1
-- -- -- --
20 16 3 10
These statistics seem to have been made with the idea of illustrating
the marvelous rather than to give the usual prolongation of these
functions. It hardly seems possible that ordinary investigation would
show no cases of menstruation between sixty and seventy, and seven
cases between seventy and eighty; however, in searching literature for
such a collection, we must bear in mind that the more extraordinary the
instance, the more likely it is that it would be spoken of, as the
natural tendency of medical men is to overlook the important ordinary
and report the nonimportant extraordinary. Dewees mentions an example
of menstruation at sixty-five, and others at fifty-four and fifty-five
years. Motte speaks of a case at sixty-one; Ryan and others, at
fifty-five, sixty, and sixty-five; Parry, from sixty-six to seventy
seven; Desormeux, from sixty to seventy-five; Semple, at seventy and
eighty seven; Higgins, at seventy-six; Whitehead, at seventy-seven;
Bernstein, at seventy-eight; Beyrat, at eighty-seven; Haller, at one
hundred; and highest of all is Blancardi's case, in which menstruation
was present at one hundred and six years. In the London Medical and
Surgical Journal, 1831, are reported cases at eighty and ninety-five
years. In Good's System of Nosology there are instances occurring at
seventy-one, eighty, and ninety years. There was a woman in Italy
whose menstrual function continued from twenty-four to ninety years.
Emmet cites an instance of menstruation at seventy, and Brierre de
Boismont one of a woman who menstruated regularly from her
twenty-fourth year to the time of her death at ninety-two.
Strasberger of Beeskow describes a woman who ceased menstruating at
forty-two, who remained in good health up to eighty, suffering slight
attacks of rheumatism only, and at this late age was seized with
abdominal pains, followed by menstruation, which continued for three
years; the woman died the next year. This late menstruation had all the
sensible characters of the early one. Kennard mentions a negress, aged
ninety-one, who menstruated at fourteen, ceased at forty-nine, and at
eighty-two commenced again, and was regular for four years, but had had
no return since. On the return of her menstruation, believing that her
procreative powers were returning, she married a vigorous negro of
thirty-five and experienced little difficulty in satisfying his
desires. Du Peyrou de Cheyssiole and Bonhoure speak of an aged peasant
woman, past ninety-one years of age, who menstruated regularly.
Petersen describes a woman of seventy-nine, who on March 26th was
seized with uterine pains lasting a few days and terminating with
hemorrhagic discharge. On April 23d she was seized again, and a
discharge commenced on the 25th, continuing four days. Up to the time
of the report, one year after, this menstruation had been regular.
There is an instance on record of a female who menstruated every three
months during the period from her fiftieth to her seventy-fourth year,
the discharge, however, being very slight. Thomas cites an instance of
a woman of sixty-nine who had had no menstruation since her forty-ninth
year, but who commenced again the year he saw her. Her mother and
sister were similarly affected at the age of sixty, in the first case
attributable to grief over the death of a son, in the second ascribed
to fright. It seemed to be a peculiar family idiosyncrasy. Velasquez of
Tarentum says that the Abbess of Monvicaro at the very advanced age of
one hundred had a recurrence of catamenia after a severe illness, and
subsequently a new set of teeth and a new growth of hair.
Late Establishment of Menstruation.--In some cases menstruation never
appears until late in life, presenting the same phenomena as normal
menstruation. Perfect relates the history of a woman who had been
married many years, and whose menstruation did not appear until her
forty-seventh year. She was a widow at the time, and had never been
pregnant. Up to the time of her death, which was occasioned by a
convulsive colic, in her fifty-seventh year, she had the usual
prodromes of menstruation followed by the usual discharge. Rodsewitch
speaks of a widow of a peasant who menstruated for the first time at
the age of thirty-six. Her first coitus took place at the age of
fifteen, before any signs of menstruation had appeared, and from this
time all through her married life she was either pregnant or suckling.
Her husband died when thirty-six years old, and ever since the
catamenial flow had shown itself with great regularity. She had borne
twins in her second, fourth, and eighth confinement, and altogether had
16 children. Holdefrund in 1836 mentions a case in which menstruation
did not commence until the seventieth year, and Hoyer mentions one
delayed to the seventy-sixth year. Marx of Krakau speaks of a woman,
aged forty-eight, who had never menstruated; until forty-two years old
she had felt no symptoms, but at this time pain began, and at
forty-eight regular menstruation ensued. At the time of report, four
years after, she was free from pain and amenorrhea, and her flow was
regular, though scant. She had been married since she was twenty-eight
years of age. A somewhat similar case is mentioned by Gregory of a
mother of 7 children who had never had her menstrual flow. There are
two instances of delayed menstruation quoted: the first, a woman of
thirty, well formed, healthy, of good social position, and with all the
signs of puberty except menstruation, which had never appeared; the
second, a married woman of forty-two, who throughout a healthy
connubial life had never menstruated. An instance is known to the
authors of a woman of forty who has never menstruated, though she is of
exceptional vigor and development. She has been married many years
without pregnancy.
The medical literature relative to precocious impregnation is full of
marvelous instances. Individually, many of the cases would be beyond
credibility, but when instance after instance is reported by reliable
authorities we must accept the possibility of their occurrence, even if
we doubt the statements of some of the authorities. No less a medical
celebrity than the illustrious Sir Astley Cooper remarks that on one
occasion he saw a girl in Scotland, seven years old, whose pelvis was
so fully developed that he was sure she could easily give birth to a
child; and Warner's case of the Jewish girl three and a half years old,
with a pelvis of normal width, more than substantiates this
supposition. Similar examples of precocious pelvic and sexual
development are on record in abundance, and nearly every medical man of
experience has seen cases of infantile masturbation.
The ordinary period of female maturity is astonishingly late when
compared with the lower animals of the same size, particularly when
viewed with cases of animal precocity on record. Berthold speaks of a
kid fourteen days old which was impregnated by an adult goat, and at
the usual period of gestation bore a kid, which was mature but weak, to
which it gave milk in abundance, and both the mother and kid grew up
strong. Compared with the above, child-bearing by women of eight is not
extraordinary.
The earliest case of conception that has come to the authors' notice is
a quotation in one of the last century books from von Mandelslo of
impregnation at six; but a careful search in the British Museum failed
to confirm this statement, and, for the present, we must accept the
statement as hearsay and without authority available for
reference-purposes.
Molitor gives an instance of precocious pregnancy in a child of eight.
It was probably the same case spoken of by Lefebvre and reported to the
Belgium Academy: A girl, born in Luxemborg, well developed sexually,
having hair on the pubis at birth, who menstruated at four, and at the
age of eight was impregnated by a cousin of thirty-seven, who was
sentenced to five years' imprisonment for seduction. The pregnancy
terminated by the expulsion of a mole containing a well-characterized
human embryo. Schmidt's case in 1779 was in a child who had
menstruated at two, and bore a dead fetus when she was but eight years
and ten months old. She had all the appearance and development of a
girl of seventeen. Kussmaul gives an example of conception at eight.
Dodd speaks of a child who menstruated early and continued up to the
time of impregnation. She was a hard worker and did all her mother's
washing. Her labor pains did not continue over six hours, from first to
the last. The child was a large one, weighing 7 pounds, and afterward
died in convulsions. The infant's left foot had but 3 toes. The young
mother at the time of delivery was only nine years and eight months
old, and consequently must have been impregnated before the age of
nine. Meyer gives an astonishing instance of birth in a Swiss girl at
nine. Carn describes a case of a child who menstruated at two, became
pregnant at eight, and lived to an advanced age. Ruttel reports
conception in a girl of nine, and as far north as St. Petersburg a
girl has become a mother before nine years. The Journal de Scavans,
1684, contains the report of the case of a boy, who survived, being
born to a mother of nine years.
Beck has reported an instance of delivery in a girl a little over ten
years of age. There are instances of fecundity at nine years recorded
by Ephemerides, Wolffius, Savonarola, and others. Gleaves reports from
Wytheville, Va., the history of what he calls the case of the youngest
mother in Virginia--Annie H.--who was born in Bland County, July 15,
1885, and, on September 10, 1895, was delivered of a well-formed child
weighing 5 pounds. The girl had not the development of a woman,
although she had menstruated regularly since her fifth year. The labor
was short and uneventful, and, two hours afterward, the child-mother
wanted to arise and dress and would have done so had she been
permitted. There were no developments of the mammae nor secretion of
milk. The baby was nourished through its short existence (as it only
lived a week) by its grandmother, who had a child only a few months
old. The parents of this child were prosperous, intelligent, and worthy
people, and there was no doubt of the child's age. "Annie is now well
and plays about with the other children as if nothing had happened."
Harris refers to a Kentucky woman, a mother at ten years, one in
Massachusetts a mother at ten years, eight months, and seventeen days,
and one in Philadelphia at eleven years and three months. The first
case was one of infantile precocity, the other belonging to a much
later period, the menstrual function having been established but a few
months prior to conception. All these girls had well-developed pelves,
large mammae, and the general marks of womanhood, and bore living
children. It has been remarked of 3 very markedly precocious cases of
pregnancy that one was the daughter of very humble parents, one born in
an almshouse, and the other raised by her mother in a house of
prostitution. The only significance of this statement is the greater
amount of vice and opportunity for precocious sexual intercourse to
which they were exposed; doubtless similar cases under more favorable
conditions would never be recognized as such.
The instance in the Journal decavans is reiterated in 1775, which is
but such a repetition as is found all through medical literature--"new
friends with old faces," as it were. Haller observed a case of
impregnation in a girl of nine, who had menstruated several years, and
others who had become pregnant at nine, ten, and twelve years
respectively. Rowlett, whose case is mentioned by Harris, saw a child
who had menstruated the first year and regularly thereafter, and gave
birth to a child weighing 7 3/4 pounds when she was only ten years and
thirteen days old. At the time of delivery she measured 4 feet 7
inches in height and weighed 100 pounds. Curtis, who is also quoted by
Harris, relates the history of Elizabeth Drayton, who became pregnant
before she was ten, and was delivered of a full-grown, living male
child weighing 8 pounds. She had menstruated once or twice before
conception, was fairly healthy during gestation, and had a rather
lingering but natural labor. To complete the story, the father of this
child was a boy of fifteen. One of the faculty of Montpellier has
reported an instance at New Orleans of a young girl of eleven, who
became impregnated by a youth who was not yet sixteen. Maygrier says
that he knew a girl of twelve, living in the Faubourg Saint-Germain,
who was confined.
Harris relates the particulars of the case of a white girl who began to
menstruate at eleven years and four months, and who gave birth to an
over-sized male child on January 21, 1872, when she was twelve years
and nine months old. She had an abundance of milk and nursed the child;
the labor was of about eighteen hours' duration, and laceration was
avoided. He also speaks of a mulatto girl, born in 1848, who began to
menstruate at eleven years and nine months, and gave birth to a female
child before she reached thirteen, and bore a second child when
fourteen years and seven months old. The child's father was a white boy
of seventeen.
The following are some Indian statistics: 1 pregnancy at ten, 6 at
eleven, 2 at eighteen, 1 at nineteen. Chevers speaks of a mother at ten
and others at eleven and twelve; and Green, at Dacca, performed
craniotomy upon the fetus of a girl of twelve. Wilson gives an account
of a girl thirteen years old, who gave birth to a full-grown female
child after three hours' labor. She made a speedy convalescence, but
the child died four weeks afterward from bad nursing. The lad who
acknowledged paternity was nineteen years old. King reports a
well-verified case of confinement in a girl of eleven. Both the mother
and child did well.
Robertson of Manchester describes a girl, working in a cotton factory,
who was a mother at twelve; de La Motte mentions pregnancy before
twelve; Kilpatrick in a negress, at eleven years and six months; Fox,
at twelve; Hall, at twelve; Kinney, at twelve years, ten months, and
sixteen days; Herrick, at thirteen years and nine months; Murillo, at
thirteen years; Philippart, at fourteen years; Stallcup, at eleven
years and nine months; Stoakley, at thirteen years; Walker, at the age
of twelve years and eight months; another case, at twelve years and six
months; and Williams, at eleven.
An editorial article in the Indian Medical Gazette of Sept., 1890,
says:--
"The appearance of menstruation is held by the great majority of
natives of India to be evidence and proof of marriageability, but among
the Hindu community it is considered disgraceful that a girl should
remain unmarried until this function is established. The consequence
is that girls are married at the age of nine or ten years, but it is
understood or professed that the consummation of the marriage is
delayed until after the first menstrual period. There is, however, too
much reason to believe that the earlier ceremony is very frequently,
perhaps commonly, taken to warrant resort to sexual intercourse before
the menstrual flux has occurred: it may be accepted as true that
premenstrual copulation is largely practised under the cover of
marriage in this country.
"From this practice it results that girls become mothers at the
earliest possible period of their lives. A native medical witness
testified that in about 20 per cent of marriages children were born by
wives of from twelve to thirteen years of age. Cases of death caused by
the first act of sexual intercourse are by no means rare. They are
naturally concealed, but ever and anon they come to light. Dr. Chevers
mentioned some 14 cases of this sort in the last edition of his
'Handbook of Medical Jurisprudence for India,' and Dr. Harvey found 5
in the medicolegal returns submitted by the Civil Surgeons of the
Bengal Presidency during the years 1870-71-72.
"Reform must come from conviction and effort, as in every other case,
but meantime the strong arm of the law should be put forth for the
protection of female children from the degradation and hurt entailed by
premature sexual intercourse. This can easily be done by raising the
age of punishable intercourse, which is now fixed at the absurd limit
of ten years. Menstruation very seldom appears in native girls before
the completed age of twelve years, and if the 'age of consent' were
raised to that limit, it would not interfere with the prejudices and
customs which insist on marriage before menstruation."
In 1816 some girls were admitted to the Paris Maternite as young as
thirteen, and during the Revolution several at eleven, and even
younger. Smith speaks of a legal case in which a girl, eleven years
old, being safely delivered of a living child, charged her uncle with
rape. Allen speaks of a girl who became pregnant at twelve years and
nine months, and was delivered of a healthy, 9-pound boy before the
physician's arrival; the placenta came away afterward, and the mother
made a speedy recovery. She was thought to have had "dropsy of the
abdomen," as the parents had lost a girl of about the same age who was
tapped for ascites. The father of the child was a boy only fourteen
years of age.
Marvelous to relate, there are on record several cases of twins being
born to a child mother. Kay reports a case of twins in a girl of
thirteen; Montgomery, at fourteen; and Meigs reports the case of a
young girl, of Spanish blood, at Maracaibo, who gave birth to a child
before she was twelve and to twins before reaching fourteen years.
In the older works, the following authors have reported cases of
pregnancy before the appearance of menstruation: Ballonius, Vogel,
Morgagni, the anatomist of the kidney, Schenck, Bartholinus, Bierling,
Zacchias, Charleton, Mauriceau, Ephemerides, and Fabricius Hildanus.
In some cases this precocity seems to be hereditary, being transmitted
from mother to daughter, bringing about an almost incredible state of
affairs, in which a girl is a grandmother about the ordinary age of
maternity. Kay says that he had reported to him, on "pretty good"
authority, an instance of a Damascus Jewess who became a grandmother at
twenty-one years. In France they record a young grandmother of
twenty-eight. Ketchum speaks of a negress, aged thirteen, who gave
birth to a well-developed child which began to menstruate at ten years
and nine months and at thirteen became pregnant; hence the negress was
a grandmother at twenty-five years and nine months. She had a second
child before she was sixteen, who began to menstruate at seven years
and six months, thus proving the inheritance of this precocity, and
leaving us at sea to figure what degree of grandmother she may be if
she lives to an advanced age. Another interesting case of this nature
is that of Mrs. C., born 1854, married in 1867, and who had a daughter
ten months after. This daughter married in 1882, and in March, 1883,
gave birth to a 9-pound boy. The youthful grandmother, not twenty-nine,
was present at the birth. This case was remarkable, as the children
were both legitimate.
Fecundity in the old seems to have attracted fully as much attention
among the older observers as precocity. Pliny speaks of Cornelia, of
the family of Serpios, who bore a son at sixty, who was named Volusius
Saturnius; and Marsa, a physician of Venice, was deceived in a
pregnancy in a woman of sixty, his diagnosis being "dropsy." Tarenta
records the history of the case of a woman who menstruated and bore
children when past the age of sixty. Among the older reports are those
of Blanchard of a woman who bore a child at sixty years; Fielitz, one
at sixty; Ephemerides, one at sixty-two; Rush, one at sixty; Bernstein,
one at sixty years; Schoepfer, at seventy years; and, almost beyond
belief, Debes cites an instance as taking place at the very advanced
age of one hundred and three. Wallace speaks of a woman in the Isle of
Orkney bearing children when past the age of sixty. We would naturally
expect to find the age of child-bearing prolonged in the northern
countries where the age of maturity is later. Capuron cites an example
of child-birth in a woman of sixty; Haller, cases at fifty-eight,
sixty-three, and seventy; Dewees, at sixty-one; and Thibaut de
Chauvalon, in a woman of Martinique aged ninety years. There was a
woman delivered in Germany, in 1723, at the age of fifty-five; one at
fifty-one in Kentucky; and one in Russia at fifty. Depasse speaks of a
woman of fifty-nine years and five months old who was delivered of a
healthy male child, which she suckled, weaning it on her sixtieth
birthday. She had been a widow for twenty years, and had ceased to
menstruate nearly ten years before. In St. Peter's Church, in East
Oxford, is a monument bearing an inscription recording the death in
child-birth of a woman sixty-two years old. Cachot relates the case of
a woman of fifty-three, who was delivered of a living child by means of
the forceps, and a year after bore a second child without instrumental
interference. She had no milk in her breasts at the time and no signs
of secretion. This aged mother had been married at fifty-two, five
years after the cessation of her menstruation, and her husband was a
young man, only twenty-four years old.
Kennedy reports a delivery at sixty-two years, and the Cincinnati
Enquirer, January, 1863, says: "Dr. W. McCarthy was in attendance on a
lady of sixty-nine years, on Thursday night last, who gave birth to a
fine boy. The father of the child is seventy-four years old, and the
mother and child are doing well." Quite recently there died in Great
Britain a Mrs. Henry of Gortree at the age of one hundred and twelve,
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