第9章

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.