Part 15

A lady who had given birth to seven daughters had subsequently five mishaps, each at four months, and every time she proved to have been pregnant of a male. Another lady consulted me, because after eight girls, she longed for a son; she became pregnant but miscarried at four months of a boy. I learnt that she had had two similar mishaps before her daughters were born.

It is safe to say that 80 per cent. of all miscarriages are the result of male pregnancies. I am able to give such a figure and to be positive as to its accuracy in my own wide experience, because of the possibility of diagnosing the sex of a fœtus at a very early stage. A striking demonstration of what can be done in this direction was given by Nagel, who distinguished a testicle in the youngest embryo ever successfully analysed with reference to sex; it was exactly five weeks old. And any abortion younger than that does not need to be considered in relation to sex determination.

All women then should be warned early in married life against any risk of miscarriage, that they may be on their guard against such deplorable results, the bane of motherhood. “Fore-warned is fore-armed,” and a huge percentage of the waste of life and energy which now prevails could be prevented if only a more sensible and normal view could be taken on the question of initiating young girls and women into the wonderful, yet simple, laws of maternity, on which all human welfare depends.

SIDE-THEORY

“Conception may take place even though there coexisted an immense amount of disease in the ovaries, provided one of them retained as much of one ovary sound as belongs to one mature vesicle.”—MORGANI.

There are and always have been so many dissentient opinions on the vital question of sex-predetermination, that it would be well to survey the multiple causes of the scepticism hitherto expressed by some biologists at the mere mention of the “Side-Theory,” since this theory forms an integral part of my principle.

The root of my argument lies in the statement that the right side contains male ova only, and the left side female. I have examined the “Side-Theory” from all points of view and studied the history of its origin from every source at my command. To satisfy the judicial and unbiassed mind, one must hear each argument and then methodically endeavour to answer one by one with irrefutable proof and evidence; only so can the truth of the theory be established, and the weakness or irrelevance of the criticisms advanced against it demonstrated. It is not an uncommon thing for a woman, for one cause or another, to have one or both of her ovaries removed.

I have gathered many instances of this, and it may be said definitely that no woman who has ever had her right ovary and tube completely removed, has ever given birth to a boy subsequently; and similarly after removal of the left ovary and tube the birth of a girl is not possible.

A few critics have written to me from various parts of the world intimating a knowledge of cases where the right ovary had been removed, and yet a boy had been born, and vice versa, drawing the conclusion that such evidence entirely disposes of my theory.

My reply to them is that I can go further, as I know not only of instances such as they draw my attention to, but others in which both ovaries have been removed, and yet children of both sexes have since been born. The explanation is perfectly simple. It sometimes happens that if the operation is not absolutely complete, a vestige of pedicle stump remains sufficient to harbour one mature vesicle, and that being so, pregnancy undoubtedly becomes possible.

Some time ago a rising young surgeon expressed the wish that he might come across one single case of a woman bearing a child, after both ovaries had been removed. Then only, he said, would he be prepared to “accept the theory of sides in its entirety.” Shortly afterwards he was able to realise his ambition. A medical friend of his delivered of twins of differing sex a woman who had actually been operated upon by that same surgeon a year or two previously, when both ovaries had been removed. From medical authorities I have been able to gather a few more such cases, to add to my own list. And it is only recently that a lady wrote to me: “I had both ovaries removed and tubes, but since then have given birth to a boy and a girl.”

Experiments on animals, after the removal of both ovaries, go to prove that they may still produce young, just as cases are recorded of certain male animals being able to fertilise a single time after being castrated, and the explanation is simple. In ovariotomy it is sometimes difficult to ascertain that all ovarian tissue has been completely removed. Some of the tissue may yet remain in the pedicle stump, and if this pedicle stump be long, one cannot say how far up the ovarian tissue may extend.

Montgomery gives a case of boy and girl twins born in such circumstances. In the postmortem on the mother only one corpus luteum was discovered, the left ovary having been removed. The pedicle stump, had, however, harboured the female Graafian follicle; hence the girl. On the right ovary, the single corpus luteum could not possibly have contained the two Graafian follicles necessary for the embryo of each sex. A lady I knew of, who had her right ovary removed, became pregnant two years later; about the third or fourth month she was taken very ill with pains in her right side and intense hemorrhage. The doctor advised an immediate operation for tubal pregnancy; this, however, was not eventually found necessary, as the trouble subsided, with the discharge of a blighted fœtus. Later, the patient was assured that this side would be of no further use to her, as the tube “had evidently burst”; thus precluding any hope of future offspring; this diagnosis proved wrong, because she has since then given birth to two sons.

Twins may arise from the same follicle, but they will be of the same sex.

Menstruation may continue after both ovaries have been removed, and invariably does so where only one has been removed. But the fact of so many women being able to conceive after bi-lateral ovariotomy, and to conceive twins of either sex, when only one corpus luteum has been found in either pedicle stump, proves to the hilt the truth of the “side-theory.”

Another striking testimony to the law of sides is afforded by tubal or uterine pregnancy. This unfortunate condition is caused by the ovum being arrested in its passage from the ovary into the uterus, and so being fertilised while yet in the tube. A morbid state of the tube, which has possibly formed adhesion with the ovary or other parts, may be due to congestion or contraction of its natural diameter. This practically never occurs except where previous children have been born and is most common where there has been abnormal distension, such as an unusually big child or twins might cause. Death may ensue from the bursting of the tube, and the results of many post-mortems on such cases have added their testimony to the correctness of my theory.

Male tubal-pregnancies are the most usual, since the right tube is the largest. Dr. Seligsen of Moscow collected fourteen cases of males in the right tube; of females developing in the left I have collected five. In one case, where a female fœtus was found in the left tube, which was removed, the mother recovered and had a boy four years later. Of the right tube I have collected six cases. In two the mother recovered without the tube having to be removed, the fœtus coming away at four months after acute pain in the right side. If, however, the pregnancy lasts for over sixteen weeks the tube invariably bursts, unless otherwise relieved.

In another case the right tube, without bursting, ejected the cigar-shaped male fœtus at four months, after severe hemorrhage. The patient recovered, but two months later a second male fœtus was ejected from the uterus, and severe ovaritis ensued. This was cured and the woman became pregnant again of another male fœtus which aborted at two and a half months. The ovaritis reappeared, whereupon an operation was performed, and the appendix was found to be adhering to and pressing against the ovary. After the removal of the appendix, the ovary promptly recovered its normal health. The original cause of this trouble had been the abnormal size of twin-boys, born some two years previously.

A girl under my observation had to have her left ovary removed, before she grew up, as the result of a severe accident; later on she married, and gave birth to six boys in succession. Another girl who also had lost a left ovary married and gave birth to a boy and then to twin-boys; since then, she has had two male miscarriages at four months; neither of these women ever had female issue.

A girl who strained herself at thirteen playing tennis, complained ever after of pains in the left groin; she married and has given birth to seven boys in fifteen years; evidently her left ovary had been rendered inoperative. Numerous instances of this kind could be given, and every case I have come across has emphatically endorsed the side-theory.

No doubt there are occurrences which seem to tell in the opposite direction. For example a male fœtus may be found growing in and distending the tube leading to the womb from the left ovary. But this can be explained quite naturally by the fact that the male ovum had journeyed from the right ovary, down the right tube into the womb, and then, instead of remaining there, had passed right across the cavity into the left tube; here it had become lodged, and so developed into a male fœtus; this is called “internal migration.” Or again it may by “external migration” have passed across the pelvis cavity, along the peritoneal surface of the intestines, to the external opening of the opposite tube—the left.

This, however, savours of an accident, and in no way disproves my theory that the right ovary produces male offspring, and the left female only. Experts have mentioned both these anomalies, but have so far offered no explanation, though Pouchet advanced the doctrine that there might be, in these cases, “aberration in the dispersion of the semen which does not follow its natural course,” of which no proof is even suggested.

Professor Scanzoni cites the case of a woman who after a quarrel with her husband, complained of severe pains in her left side and died that night. On examination a laceration was found on the left side of the uterus, in which were the membranes and placenta of a fœtus, but there was every evidence that the ovum had originated from the right ovary.

A Mrs. C., after the birth of two girls, employed my formula and became pregnant of a boy; at the third month the pregnancy, which proved to be tubal, was terminated by the bursting of the tube which had subsequently to be removed. The mother was saved, and it was found that, though the child was a boy, the offending tube was the left one; and apparently since the birth of the last girl this tube had remained abnormally enlarged, and in an unhealthy condition, thus causing this anomaly. Eighteen months later the lady conceived again; she miscarried of another boy, and the right ovary was left in a state of acute irritation and bound down with adhesions. It is some years since this happened, and she has now succeeded in regaining her normal health and has at last produced a much-needed son and heir.

“Placenta prævia” proves the complete vertical journey of the ovum; in such cases, the ovum, having arrived in the womb, drops vertically downwards to the lower part of that organ, instead of becoming embedded in the upper part. Fertilisation ensues and the fœtus becomes attached to the mouth of the womb, and if the child goes full time it is usually born dead. Ovarian pregnancies are equally dangerous though fortunately rare.

Such abnormalities in no way reflect on the truth of the side theory; on the contrary the abundant evidence I have collected corroborates in every particular that the right side is proper to male issue, the left to female.

XVI

TWINS OF MIXED SEXES