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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