Part 9

In this connection, I might quote a letter which a lady wrote to me two years ago from India:

I have three little girls and my periods are quite four or five days before the fourth week and always very profuse. I am very anæmic, partly owing to the climate out here. I do so long for a son....

I sent her the advice she requested. Last year she had her wish fulfilled, and, since his birth, the periods are much more normal and rather inclined to be “late” than “early.”

On the other hand I received a letter from another lady saying:

My periods are usually every five or six weeks. Yet I am quite healthy and have never had a miscarriage. I have five sons ... my periods are always rather “late,” but I am very strong and well.

And this leads me to the subject of menstruation, which is generally so closely allied to that of ovulation. In England most girls begin menstruating at 13 years, though large numbers start at 14 or 15, or even later. But according to the record kept by Mr. Robertson of 450 cases, 10 menstruated in their 11th year, 19 in their 12th and 53 in their 13th. He also gives us particulars of great numbers of women menstruating well on to the age of 55, two cases of women doing so till 60, and one of a woman menstruating up to her 70th year.

In cold climates, women frequently menstruate three or four times a year only, and they begin later and end later. In Russia it is not unusual for women to bear children as late as 60, whereas with us it is rare to have a child after 45. Capuron quotes several cases of child-bearing in advanced age. Among these he gives the case of Cornelia, as recorded in Pliny. She was a member of the family of Scipio, and at the age of 60 she bore a son, Volusius Saturinus. Another case he quotes is that of a Venetian physician named Marsa, who treated a woman of 60 for pregnancy, having previously, owing to her age, diagnosed her trouble as dropsy. He adds that a woman in Paris bore a daughter at the age of 63 and nursed it.

It is rare in England to conceive for the first time at 45, but I have known three women who had a first child at 47, and two at 48. Yet so great is the latitude in the ages of women’s fruitful period that a girl may be a mother at 12, or even earlier in hot climates.

La Motte delivered of a child a girl who had not completed her 13th year, and who had not menstruated. Dr. Paris states that during the year 1816 some girls of 13 were admitted into the Maternité at Paris, and recently the Matron of a London home has given me particulars of two or three cases of mothers of 13 and 14.

Dr. Rowlett, of Kentucky, reports the case of a certain Sally Deweese, born in 1824, who began to menstruate at a year old. At nine years old she became pregnant, and in 1834 gave birth to a female child weighing 7¼ lbs., the mother then being 4 ft. 7 in. in height. It should be noted that in cases where the mother is quite elderly or where she is a mere child, the progeny is rarely healthy or strong. In the former category the child more often suffers from lack of full mental development, and in the latter it rarely survives its birth.

Having made a brief survey of the question of sterility in women, I may now state my conclusion that most disabilities are remediable, or at least capable of great modification. Much depends on the woman herself—her health, mode of life and temperament. Conditions and the proper choice of a day can help, but where there is some organic or anatomical disability, the advice of a surgeon or a doctor should immediately be sought. In few cases, from my experience, is sterility absolutely hopeless, though in many instances where a girl-child can be conceived, a boy would be impossible, and the attempt should not be made, as it might cause lasting injury to the mother.

I must confess that when the causation of sex loomed large on the horizon of my mind I little thought that the simple natural laws I had discovered would prove such an efficient aid in the treatment of sterility as has since been shown so abundantly to be the case.

VIII

SEX-CAUSATION

“The sex of the child is fixed before it is fertilised.”—LENHOSICK.

Before I go on to describe the simple law of nature on which the pre-determination of sex depends, it is essential that a few anatomical details should be explained and understood. A fundamental truth to be borne in mind is the absolute completeness of the maternal organs. They harbour from the first moment of actual existence the potentialities of both sexes alike, entirely independent of the fertilisation of the male parent. Of what then do the uterine organs consist? Let us first treat of the position of the uterus or womb. This organ begins to develop with the first beginning of menstruation, and it goes on growing until the twenty-first year. Once it has borne a fœtus it never entirely regains its virgin form, but remains slightly enlarged. It lies rather to the right, so that when a woman is on her back, the right ovary and the uterine opening of the right oviduct or Fallopian tube are lower down in the pelvis than the left ovary and oviduct. On either side of the womb are the Fallopian tubes, their average length being four inches. These tubes are dilatable, smaller at the uterine opening and thicker at the abdominal opening near the ovary. Each tube is lined with mucous membranes which, containing special hair-like fibres called “cilia,” impel the ovum, or egg, onwards down the tube by a movement always in one direction, towards the uterus. These tubes are the excretory ducts of the ovaries.

The ovaries grow and mature earlier than the womb. Each ovary is a solid oval-shaped organ more or less encircled by the outer end of its corresponding Fallopian tube, and each enlarges when about to discharge an ovum. The right ovary is larger than the left. In each are a large number of cysts known as ovisacs or “Graafian follicles,” so called after R. de Graaf, a Dutch anatomist, who died in 1673. Each Graafian follicle contains an ovum floating in a clear albuminous fluid, called “liquor folliculi.” At birth there are thousands of ova in the ovaries, but by the time of puberty only one-third remain. Each follicle contains an ovum and each ovum a vital structure called the germinal vesicle or nucleolus. This, when fertilised by the corresponding contribution from the male, grows and develops into the ultimate child.

Ovulation, i.e. the discharge of a ripe ovum from an ovary, is brought about by the development and maturing of a Graafian follicle, its rupture and the discharge of the ovum it contained. The enlarged follicle having gradually approached the ovarian surface, its walls become congested and thinned at one part. It then bursts; the “liquor folliculi” is poured out, and the ripened ovum set free. Ova, one or more at a time, are expelled from the ovary at regular monthly intervals, from puberty to the climacteric, for some 35 years. Before puberty a girl’s ovaries are pearl-grey and smooth, but later each ovulation leaves a little scar. For every monthly period a scar remains, and, as there are some 500 menstrual periods in a woman’s life, there should be in all some 250 scars on each ovary, though most of these are entirely obliterated in the course of time.

As the ovaries are formed in the embryo fœtus so is their sex determined, and they are potentially male or female from the start. The ova, in their thousands, lie latent in each ovary of the female until puberty supervenes. Then, alternately, every month or thereabouts, starting always from the left, each ovary expels its ovum, and does so with increasing regularity as adolescence ripens into womanhood. According to the sex, if at any time the ovum be fertilised and pregnancy ensues, an indelible scar will be left on the one ovary or the other.

It is only of late years that the theory of the alternate action of the ovaries has been recognised by certain eminent gynæcologists. The evidence afforded by the ovaries themselves admits of little possible doubt as to the fact of equal division of activity between right and left side of the womb. Such action is not simultaneous, but definitely alternating in character.

A woman doctor in Geneva, 35 years ago, made a close study of the fact that young girls frequently complained of pains one month in the right side and the next month in the left. She also pointed out a dissimilarity between the two periods for two months running. These observations combined with others, carried weight in the minds of many prominent doctors, hitherto sceptical of the alternate working of the ovaries, and the theory of “sides.”

To my mind, as the result of long and close investigation, the conclusion is definitely established that the side theory cannot be seriously questioned, and any attempt to overthrow it would result only in putting back the hands of the clock.

Dr. Rumley Dawson’s clearly stated account of the alternate working of the ovaries is too well known to need reiteration in this treatise. It is entirely consistent with the principle, by which as Professor Gamble lately stated, Nature makes provision for all parts of the human body to rest at intervals while other parts are employed, thereby enabling the organs to “work in shifts.” The theory in itself is time-honoured, and many authors can be quoted in support of it. The left side is the first to operate in the young girl, and it is usually the first to push forward the work of conception in the woman. Hence the preponderance of females among all first-born creatures.

In the early stages of life most children are left-handed, they even start walking left foot foremost. As they grow, however, the right side in time takes precedence. The right leg is the strong one to jump from, the right arm wields the weapon with which we work or fight. Similarly the whole right side of the human body is definitely superior in enduring power to the side where beats the heart. In more ways than one must this organ be held responsible for the weaker fibre of the position it dominates.

If there is one exception to this rule it is the brain, of which the left side gets a more rapid supply of blood, and thus shows more activity than the right.

On the other hand in tubercular hip-disease, the left leg is affected in 80 per cent. of cases. Congenital dislocation of the hip is seven times more common in female children than in male. Prenatal and spontaneous amputation of fœtus limbs is usually to be found in girls only. The disaster of being joined together, like the Siamese Twins, is more often suffered by girl-twins, only a very few similar cases among boys being mentioned in medical records at any time. In phthisis, the left lung is the first to be affected in 80 per cent. of all cases recorded. The teeth on the left jaw are the first to arrive, and likewise the first to decay or drop out, with but few exceptions. Again the right hip, leg, foot and hand are almost always larger than the corresponding members of the left side.

So, too, it comes about that the right ovary, the seat of the male ova, is also the more developed, the larger, and the best able to nourish the fertilised embryo. It can afford fuller space and freedom for male offspring than the left ovary can do for the female ova it produces.

As regards the reason why there should be one side for each sex, one might as well inquire why the heart is on the left and the liver on the right. Galen has said that “the right side in both parents produces boys, because it is warmer.” But many people would have judged the side governed by the heart to be the warmest. Be that as it may, the fact remains that in France brides are seriously advised to sleep on the right side if they desire sons, and in 1870 the Lancet observed that “habitual sleeping on the right side produces boys.”