Outlines of the diseases of women / by John Phillips.

  • Phillips, John.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Outlines of the diseases of women / by John Phillips. Source: Wellcome Collection.

    77/332 (page 57)
    visible, while in four months it has quite disappeared; should pregnancy occur, other changes are said to take place, which will be found described in works upon obstetric medicine. The above series of phenomena then are supposed by the majority_ of observers of the present clay to occur at each menstrual period, and further that the rupture of a Graafian follicle is the exciting cause of the uterine hemorrhage and other signs of menstruation. There are, however, certain facts which must be mentioned here, as they are opposed to the above expressed views. 1. Ritchie, as early as 1843, contended that the Graafian follicles of the human female do not require the establishment or presence of menstruation for either their development or rupture. He proved that normal follicles became matured as early as the sixth year of a child's life and expelled their contained ova, and yet menstruation did not occur. Jacobi and others admit theformation of the follicles during childhood, but think that having attained their full size, they do not rupture, but undergo a physiological involution. 2. According to the statistics of Mr. Lawson Tait, 30 per cent, of his cases, in which both ovaries had been removed, menstrua- tion was not only not interfered with, but increased in quantity. This is met by the objection that it is often impossible to be sure of removing all ovarian tissue, the slightest portion remaining would be sufficient to keep up menstruation. 3. It is stated that in many cases of patients dying during menstruation, no ripe or recently ruptured Graafian follicle has been found post-mortem. Sir John Williams thinks that rupture takes place before the appearance of the flow with which it is connected. 4. Lastly, we have the undoubted clinical fact that a woman may conceive during suckling or in advanced phthisis without menstruation being present. Tait concludes that ovulation or the extrusion of a Graafian follicle is less frequent than menstruation, and certainly not concurrent with it or causing it: he explains the rupture of a follicle and the appearance of the discharge being occasionally simultaneous, by supposing that they each have a certain cycle, revolving at different rates; at intervals therefore, they must coincide. Changes in the Uterus during Menstruation.—It is generally agreed that the endometrium is the source of the hemorrhagic discharge, that the cervical mucous membrane is passive, and that the Fallopian tubes, so far as their lining membrane is concerned, take no part in its production. We must remember that it is considered that the endometrium is peculiar in having no true submucous layer ; but an interesting