Their Causes—The Catamenial Discharge as affecting it—Fluor Albus—Corpulency—The Treatment appropriate in these Cases.
When a woman is not able to conceive, the defect must depend upon a malformation, a diseased state, or a diseased action of the generative organs.
Causes.—Organic barrenness happens in those cases where there is some structural hindrance or defect, either natural or accidental. The vagina may be imperforate, so as wholly to preclude the intermission of the seminal fluid; the ovaria may be either wholly wanting or too small; or the Fallopian tubes imperforate; or the uterus so small as not to be capable of its proper functions. The hymen may also be so hard and resisting as to prevent the natural measures for conception.
In most cases of barrenness, however, the organs of generation appear to be properly formed, but their action is imperfect or disordered.
If the menses have not appeared, or if the discharge is scanty, and occurs at irregular periods, the woman rarely conceives.
So also when the menstrual flux is more frequently repeated than it is in its natural course, or when it occurs even after the proper time, in too great profusion, and, as is generally the case, intermixed with genuine blood, there is little prospect of conception taking place. In such cases there often appears to be as little desire for cohabitation as there is power of fecundity.
Pregnancy seldom happens when the catamenial discharge is attended with great and spasmodic pain, particularly if the discharge is small in amount, and of deteriorated quality. If, under such circumstances, conception does take place, the next periodical flow is very apt to cause the uterus to discharge the germ, thus bringing on an early miscarriage.
The state of weakness and debility of the uterine system occasioned by too frequent sexual intercourse, is a common cause of sterility. Those unfortunate creatures who follow a life of prostitution seldom bear children.
Bad cases of fluor albus often indicate a state of the uterus and ovaries which does not admit of conception.
There is also to be mentioned, among the causes of barrenness, what has been called by medical writers copulative incongruity. “Every one,” observes Dr. Good, “must have noticed occasional instances in which a husband and wife, apparently in sound health and vigor of life, have no increase while together, either of whom, nevertheless, upon the death of the other, has become the parent of a numerous family; and both of whom, in one or two curious instances of divorce, upon a second marriage. In various instances, indeed, the latent cause of sterility, whatever it consists in, seems gradually to diminish, and the pair that was years childless is at length endowed with a progeny.”