menstruation is over, a feeling of improved health exists, and the sexual appetite is particularly manifested. The most complete correspondence is therefore found in this respect."

"Moreover, all intelligent anatomists, physiologists and physicians have for a long time been convinced that the cause of menstruation, as well as of sexual instinct, is in the ovaries; and that the uterus, on the contrary, though by it the sexual apparatuses in the different classes and genera of animals have been typified, is, in this relation, quite of secondary importance. Numerous cases in pathology the most diverse in character, and numerous deviations from the normal type (malformation), concur entirely in this respect."

"Quite recently direct anatomical proofs of these statements have been furnished. It now does not admit of a doubt that the ovary, at the time of each menstruation, is in a state of great excitement--that a Graffian vesicle is considerably developed bursts, and a corpus luteum is formed in its place. The investigations of Robert Lee, Bateman, W. Jones, Negrier, Gendrin, Raciborski and Pouchet remove from this question every vestige of a doubt. I, myself, have had occasion four times to make examination bearing on this point, all confirmatory of the same fact."

"Finally comes the long-known fact, that females conceive most certainly immediately after menstruation, and examples are not wanting where this occurred with some only at the time of menstruation. Prof. Nægele has told me that he has never been deceived in regular cases when reckoning nine months and eight days from the last period, and that he had removed cases of barrenness by advising copulation immediately after or even during the flow."

"In the human female, during menstrual life, the maturation and discharge of an ovarian ovule takes place every four weeks, accompanied by a contemporaneous discharge of blood. This periodical maturation of an ovule is the primary and principal condition on which conception and pregnancy depend; at no other period is it possible."

It is seen here that this accurate experimentor does not make the well-being of the foetus in the least dependent upon the periodical determination of blood to the uterus, which excess, after conception, is turned to the feeding of the foetus (as still taught by some). Such engorgement is a result, and, with its resultant flow, epiphenomenal. Again: "It appears that the discharge in the uterus begins while the ovule is still in the Graffian vesicle, and that it is not detached till the cessation of the flow, while in the tube it is probably capable of being fecundated for several days if coition supervene. How long? This can only be settled by direct observations, which are as yet altogether wanting. Thus much, however, I believe, may be received as certain -that fecundation must take place in the tubes (that is, before the ovum has arrived at the uterus), because here, very probably, development begins."

"The ovum of the rabbit remains in the tube three, that of the rodentia four or five, and that of the bitch eight or ten days; as far as we know, then, we may suppose that the human ovum still exists for from eight to twelve days after its discharge from the ovary, and, therefore, that for eight or twelve days after the menstrual flow has ceased the ovum is susceptible of fecundation. I have often been

asked if conception is dependent on menstruation, and this on the maturation of an ovum, how is it possible that females conceive, never having menstruated? I answered to this by simply stating that, though the discharge of blood is a normal and easily cognizable symptom of the maturation of an ovum, the latter is, nevertheless, not essentially dependent on it, as a single glance at the animal kingdom proves. This periodic maturation of ova is there seen, both with, and oftener without, such discharge of blood. Menstruation (the menstrual flow) then is, in the human female, an entirely normal and important, though by no means essential, but rather accidental symptom of ovulation. It may be wanting and yet ova mature, and be, therefore, susceptible of development and fecundation. If the human female menstruated but once or twice a year, it would long ago have been remarked that these were the only periods at which conception was possible; menstruation would long ago have been recognized as perfectly analogous to the heat in animals, even though the most important element, i. e., the maturation of the ovum, had not been discovered. As, on the one hand, menstruation occurs every four weeks, and, as conception is so often possible, it was not easy to fix the limits within which it was to be restricted without further observation; and, on the other hand, menstruation passes by so often without its purposes, i. e., conception being attained, it was quite natural that attention should be directed more toward the former than to the dependence of the latter upon it. In animals. just the reverse relation opposes a correct appreciation of the analogy between the heat and menstruation. With them the heat occurs either very rarely, once or twice a year; if oftener--as in the cow, the ewe, the sow, &c. the common circumstances and purposes in domestic economy cause that this relation is obscured, either by the fact that the animals are immediately fecundated, or the maturation of the ova is prevented or retarded by lactation. This is the reason why the very remarkable analogy offered by the cow has, for the most part, remained unnoticed. As to the researches of anatomists and physiologists, they have but recently made any correct observations, being previously deluded by false theories. "The proper opportunities for observation on the human female were rare; menstruation, the maturation and discharge of ova, is usually so dependent on the general health that the disturbance of it nearly always precedes death. It is only after death by violence that we can hope, in healthy persons, on dissection, to make observations bearing upon this subject."

I have thus given, at much length, the arguments founded upon his experiments, of this ablest of physiological experimenters, Bischoff. Now, these arguments and experiments are to prove: 1st, that the periodical heat in the lower animals was connected with, caused by, the periodical maturation and discharge of a Graffian vesicle, an ovum or ova, and the formation of a corpus luteum, and this independent of coitus; 2d, to prove that the menstrual period in the human female was analogous to this heat period in animals, and, consequently, that the menstrual hemorrhage was not only coincident with, but dependent upon, caused by, the periodic maturation and rupture of vesicles, discharge of an ovum; 3d, to show that the capital act of menstruation was ovulation, while the menstrual flow was a concomitant only. And all these points we conceive he has abundantly, almost superabundantly, proven; and, as these points embrace fully the matter in controversy before the Society, I might leave the argument with Professor Bischoff; but, lest some should hold

to the time-honored views of periodic uterine engorgement, for the purpose of nourishing a future fœtus, &c., we shall, at the risk of being tedious, proceed with other proof.

Dr. Robert Lee, the distinguished Professor of Midwifery, London, so early as 1840, says: "There are certain facts which seem to prove that it is to ovarian, and not to uterine, influence we are to attribute all the changes which take place in the female pelvis, mammæ and uterine system at the period of puberty, and that it is to certain changes in the Graffian vesicle all the phonomena of menstruation are to be referred." In proof that menstruation is ovulation, he gives a number of dissections of women dying during the menstrual epoch, in all of whom recent ruptures of Graffian vesicles were observed. In further proof of this view, he refers to the published observations of Cruickshanks; also, to cases given in Robert Hooper's large work on Morbid Anatomy.

We next quote Dr. Rudolph Wagner, Professor in Goettingen. In his great work on Physiology, "Handwarterbuch der Physiologie," after having shown that the menstrual period in the human female is analogous to the oestrual in animals, says: "If this be the case, then are we forced to the conclusion that it is connected with, and dependent upon, the maturing and casting off of an ovum, as experiment upon the living animal demonstrates this to be the accomplished fact in the oestrum of animals. And, since the works of Pouchet, Raciborski and Bischoff on the co-existence of menstruation and the rupture of vesicles and the formation of corpora lutea; and, since the contemporaneous writings of W. Jones, Lee, Patterson, Montgomery, and others, it has become an established fact that the time of menstruation coincides with the maturing and bursting of a Graffian vesicle. In every case where a married or unmarried woman died during or soon after menstruation, there was found, on dissection, a fully matured or already broken follicle. The labors of Eker, Janker, Ritchie, Arganti, Serres, Hyrtle, Locatelli, Latheby, Coste, H. Heckel, Hainold, Garloch and Dalton confirm this fact."

He further says: "The maturation and casting off of an ovum is independent of the influence of the male sperm, as is proved by cases of occlusion of the Fallopian tubes by disease or ligature, and by cases of imperforate Hymen." He leaves it an open' question whether the ovum is thrown off at the beginning, during, or immediately after, the menstrual flow. And this, we will here add, doubtless, happens both immediately before, at the commencement, during, or after, the flow, this depending upon many conditions easily accounted for. And, as we have found that, while the law is, that this maturation or bursting of the vesicles produces the entire phenomena of menstruation, with the menstrual flow, such is not always, or necessarily, the case, as in those cases of conception where a menstrual flow had never taken place. Nor do we see any objection to the supposition that, in its operation, this law may meet an exception in a reverse direction-that is, that, after having excited the concatenation, usually resulting in the menstrual flow, the menstrual exciting vesicle may not rupture at all, but take on a retrograde movement. And, could a single case, or a few rare cases of this nature be cited, it would be no greater argument against the ovulation theory than the occasional existence of tubal or abdominal pregnancy is against the uterus being the natural place for foetal development.

But what was at the time of most interest in this most varied research and conclusive argument of the learned and philosophical Wagner, was his citation of cases that had been long inferred, but not proven in which the ovum in the Fallopian tubes of the virgin human

female, following menstruation, had been actually discovered. The indefatigable Bischoff had seen the ruptured vesicles and corpus luteum; but failed in what he was so anxious to do-to discover the ovum itself. Now, while scores of able observers bad placed the coincidence of the menstrual flow and the maturation and rupture of a vesicle beyond reasonable doubt, it was not generally known that the ovum had been actually discovered. And that it should have been discovered at all is rather surprising, as it is of almost microscopical size, and about the time of its escape the Fallopian tubes are filled with blood, and the lining membrane of the uterus engorged, corrugated and bloody. Wagner, however, refers us to several cases where it had been discovered. The first is given by Hyrtle, in his Anatomy of Man, in which he states that he has found the ovum in the Fallopian tubes of a girl fifteen years of age, who died during her first menstruation. Two more cases are referred to by Wagner, published in the_Philosophical Magazine, 1851, Vol. II, No. 11. In both cases the Hymen was intact. The girls died during the menstrual flow. Since then several other cases have been published.

Dr. Fleetwood Churchill, in his classical work on Midwifery, endorses the ovulation theory, and, after summing up numerous cases from various authors, "all of whom," he says, "agree that in the female, during, or soon after, menstruation, a small, irregular rupture was found in the ovarium, and that this communicated with the remains of a ruptured Graffian vesicle." From all this evidence we are obliged to conclude that there is a periodical ovulation of Graffian vesicles, and that this occurs at a menstrual period. In support of this view his American editor, Dr. Condie, cites a number of cases from different authors.

Dr. Bedford, Professor of Obstetrics in the University of New York, in his work on Diseases of Women and Children, says: "The reason why the physiological function of menstruation does not exist before puberty is, that the organs of which it is the function have no physiological existence previous to this time. These organs are the ovaries, the essential and only organs of generation, strictly so-called, in the female. The development of the ovaries occurs at the period of puberty, and then it is their physiological action commences. At this time you will observe on their surface the Graffian vesicle, this latter containing the ovule which I have told you escapes ordinarily with the menstrual blood. As these ovules on the surface become matured, the ovary itself forms the centre of a sanguineous afflux, a veritable congestion, in which the Fallopian tubes and the uterus participate. This congestion results in the escape of mucus and of blood, which passes from the uterus into the vagina, and thence escapes externally-and this is menstruation. But why is this function of menstruation periodical? If you examine an ovary in its congested state, you will observe on its surface the matured ovule of which I have spoken, or at least the ruptured vesicle from which it has escaped; examine this organ still more closely, and you will find imbedded in the subjacent tissue other ovules which are not matured, but which, as they approach the surface of the ovary, become so precisely as did the first. So in this way there is, at each monthly crisis, a constant succession of ovules to be observed, which either become fecundated by the seminal fluid of the male, or, in the absence of such influence, escape with the catamenial

fluid.

This periodical maturation of the ovules continues from puberty to the cessation of the menses. Previous to puberty the ovaries are undeveloped, have no action; after the function has ceased they become atrophied. This similarity of condition of the ovaries before and after the child-bearing age is explained in this way-menstruation is, as it were, but the result of the ripening of the ovules, which the female furnishes as her part in the great work of increase.

"The reason, therefore, that her ability to perform this latter duty is restricted to certain limits is, because it is only within these limits, from the period of puberty to the cessation of the menses, that the ovaries are capable of secreting ovules."

Surely this is sufficiently explicit. The whole question in controversy is fully stated and entirely accorded us-1st. The cause of the periodic orgasm is stated to be in the ovaries-ovulation; 2d. The menstrual flow the result-a concomitant only--a secondary result: as, first, we have ovarian excitement, which is periodical, secondly, a resultant engorgement of the uterus, and, as the result of this, the menstrual flow. Menstruation is considered, stated, by Dr. Bedford to be the physiological action of the ovaries-ovulation. And, as this is not a question of thought, but of direct observations, the matured opinions and extensive observations of such a man cannot be ignored. Dr. Hodge, Professor of Obstetrics in the Pennsylvania University, without arguing the question, assents to the theory of ovulation as an established physiological fact.

Prof. Miller, of the Louisville University, in his work on Midwifery, says: "In the human female ova are matured and emitted at the menstrual period, between which and the incalescence of the inferior animals there are many points of resemblance. Ovulation may be performed in exceptional cases without the menstrual flow; but menstruation (the menstrual flow) is so closely dependent upon the ovaria that if they be wanting or dormant, it is suppressed. Nor is the flow of blood from the uterus the only or principal phenomenon at the ovular epoch. Important changes take place in the uterus; it becomes engorged, turgesent, so that the opposite sides of its cavity are in contact and its membrane thrown into convolutions. In such a condition of the uterus the ovum is intercepted, caught between the mucous folds, and hindered from falling headlong to its most dependent part. Should it be fecundated it is in a position safest for the mother and itself; if not fecundated, it will be allowed to pass away, when the orgasm raised for its behoof shall subside."

This testimony, again, is sufficiently unequivocal. To state that "the menstrual molimen is so intimately dependent upon the ovaria, that if these be wanting or dormant it is suppressed," is to give them the relation of cause and effect-the cause, periodical ovarian excitement; the effect, bloody discharge. And this is the ovulation theory. And, as Prof. Miller makes all the changes taking place in the reproductive organs of the female at and during the menstrual epoch immediately dependent upon the changes going on in the ovaries, his whole testimony is unequivocally in support of our proposition. And the large experience and extensive observations of Prof. Miller entitles his opinions to much weight on a point which, like this, is determined by experiment and observation.