The time at which menstruation, and consequently child-bearing ceases, will be materially influenced by that at which it commenced; with those who commenced at ten or twelve, the discharge often ceases before the age of forty; but where the first appearance has been protracted to sixteen or eighteen, such women may continue to menstruate until they have passed the fiftieth year; but in this climate the most usual period of cessation is between the age of forty-four and fifty,[[403]] after which women never bear children, although we have in ancient[[404]] as well as in modern times, many extraordinary examples of protracted fecundity, to which but little credit ought, in general, to be attached. Marsa, a Venetian physician, relates a case of a woman who at the age of sixty brought forth a daughter, and suckled her, and whom he had previously treated for what he had considered to be ovarian dropsy; the annals of our own country[[405]] would furnish some extraordinary instances of a similar kind. Dr. Gordon Smith illustrates the subject by the case of the wife of a peruke-maker in Poland-street, in the year 1775, who at the age of fifty-four produced two sons and a daughter, although she had been married for thirty years, and had never before been pregnant.
It is probable that many of those “well authenticated instances” of old women having menstruated, like those recorded of children, are merely sanguineous discharges from the vagina, or from a diseased uterus; this we have no doubt is the true explanation of the case related by Richerand,[[406]] of a woman, who at the age of seventy had not ceased to menstruate.
Q. 8. What is the possible number of Children that can be produced at one birth?
According to the most accurate estimates, Twin cases, on an average, occur about once in ninety labours; Triplets are considerably more rare, they are stated not to take place more than once in three thousand times; and the occurrence of four at a birth is so rare an event, that no calculation has been formed upon the subject. The reader will find a very interesting paper on the “Plurality of Births,” by Dr. Garthshore, in the 77th volume of the Philosophical Transactions, to which we beg to refer him. Dr. Osborne states that he has distinctly traced as many as six fœtuses in an abortion.
It is a curious fact that the relative number of males and females born is nearly equal, there being only a small majority in favour of the former, in the proportion of 21 to 20; in consequence of which both sexes are equal at the age of 14, since more male children are still-born, or die in infancy, than females, owing, as Dr. Clarke[[407]] has supposed, to the relative size of the head, being greater in the former. Hufeland[[408]] has collected the relative number of the two sexes in all parts of the world, and has found them every where the same. “It seems very singular,” says Sir Gilbert Blane,[[409]] “and at the same time most admirable in the institution of Nature, that this relative number of the sexes should be maintained, though the primordial germs are mixed in different proportions in the ovaria of different females; for it is well known that many women produce such a number of children in succession, of the same sex, as is utterly irreconcileable with the laws of blind chance, another word for mathematical necessity.” The reader will also derive much pleasure by the perusal of a memoir[[410]] upon this subject by Dr. Arbuthnot, entitled “An Argument for Divine Providence, taken from the constant regularity observed in the birth of both Sexes” from which the learned author deduces as a scholium, that polygamy is contrary to the law of Nature and justice, and to the propagation of the human species.
Q. 9. Is Super-fœtation possible, and under what circumstances, and at what period of Gestation can a second conception take place?
The term Super-fœtation implies that a second impregnation may take place, whilst a child is in utero.
There are perhaps few questions relating to the subject of conception, that have given origin to more rigorous controversy; and indeed its important judicial bearings render it a subject of greater interest than it could ever have become intrinsically as a mere object of abstract speculation. Let us, for the sake of illustration, suppose the following case:—A woman loses her husband suddenly, tenant in tail male, a month after marriage, and at a little more than eight months after his decease she is delivered of a perfect female child, and at nine months, she declares that she is delivered of another infant, which is a male. The heir at law, who has entered, contests the fact of this latter birth; the question therefore to be determined is, whether such an event is compatible with the known laws of utero-gestation.
The ancient physicians and philosophers undoubtedly believed in the possibility of super-fœtation; and the Mythology contains a well characterised example in the instance of Iphicles and Hercules, who were begat upon Alcmæna, the former by Jupiter, and the latter by Amphitryon. Hippocrates,[[411]] Aristotle,[[412]] and Pliny,[[413]] entertained no doubt respecting the fact, and in later times we find that the most eminent physiologists have sanctioned the same belief, and have been engaged in recording facts in its support. Gasper Bauhuin[[414]] relates a case in which a woman at the end of nine months brought forth a dead child, with a deformed head, and that six weeks afterwards she was delivered of a well formed child which lived. Buffon[[415]] presents us with a still more striking example; a woman of Charles-town, in South Carolina, was delivered in 1714 of twins, which came into the world one directly after the other, but to the great surprise of the midwife, one was black and the other white; the woman herself, considering this proof of her infidelity too obvious to be denied, admitted the truth without hesitation,—that shortly after having enjoyed the embraces of her husband, a black servant entered her room, and by threats accomplished his purpose. Aristotle[[416]] speaks of an adultress who produced at the same birth two sons, the one of which resembled the husband, and the other the lover; Pliny[[417]] also relates several cases of super-fœtation, some of which are certainly no other than twin cases, and the others are merely copied from Aristotle. Musa Brassavolus[[418]] has the following remarkable observation upon the subject. “Nos vidimus super-fœtationem quandoque fuisse epidemicam affectionem.” Zacchias[[419]] also believes in the phenomenon; and in the case of one Laurette Polymnie, his testimony secured for her child the rights of inheritance; Harvey[[420]] likewise relates a case of super-fœtation, to which we beg to refer the reader; Haller[[421]] expresses his opinion in the following words: “Os uteri nunquam clausum est; ideoque potest super-fœtari non solum a die sexto ad trigessimum, aut primis duobus mensibus, sed omni omnino tempore.” Zacchias[[422]] however, thinks that it can only take place in the first two months of pregnancy, for that after this period, the developement of the fœtus renders it impossible. Plouquet observes, that immediately after a first conception, a second may easily take place, but that after a few months it can only occur under the most extraordinary circumstances. If time and space would allow we might adduce a considerable mass of similar testimony, but we shall conclude this part of the subject with the opinion of Kannegeiser, “De super-fœtationis existentia rationis quippe principiis, atque infinitis hominum et brutorum exemplis abunde comprobatu, Medicis atque jurisconsultis mens vix amplius hæret in ambiguo.”[[423]] The best authenticated case of super-fœtation that has occurred in our own times is that communicated to the College of Physicians by Dr. Maton:[[424]] Mrs. T—— an Italian lady, remarkable for her fecundity, was delivered of a male child at Palermo, on the 12th of November, 1807, under very distressing circumstances, having been dropt on a bundle of straw in an uninhabited room at midnight, and although the infant at the time of his birth had every appearance of health, he lived only nine days; on February the 2d, 1808, (not quite three calendar months from the preceding accouchement) Mrs. T—— was delivered of another male infant, completely formed, and apparently in perfect health; the child however fell a victim to the measles at the age of three months. Dr. Granville, in a paper entitled “On the Mal-formation of the Uterine System,”[[425]] takes occasion to observe with respect to the above case, that “it merely goes to prove the occasional co-existence of separate ova in utero, and proves nothing farther; the lady, whose prolific disposition is much descanted upon in that paper, and with whom twin cases were a common occurrence,” continues Dr. Granville, “was delivered of a male child sometime in November, 1807, ‘under circumstances very distressing to the parents, and on a bundle of straw,’ and again in February, 1808, of another male infant, ‘completely formed!’—mark the expression, for it was not made use of in describing the first. The former died ‘without any apparent cause’ when nine days old; the other lived longer. Now can we consider this otherwise than as a common case of twins, in which one of the fœtuses came into the world at the sixth, and the other at the ninth month of pregnancy, owing to the ova being quite distinct and separate? Had this not been the case, the distressing circumstances, which brought on the premature contraction of the womb, so as to expel part of its contents in November, as in the simplest cases of premature labour, would have caused the expulsion of the whole, or in other words, of both ova, in that same month; and we should not have heard of the second accouchement in the following February; which led the author of the paper in question to bring the case forward as one of superfœtation, in opposition to what he has called ‘the scepticism of modern physiologists.’ Had it been proved that the child, of which the body in question was delivered, had reached its full term of utero-gestation in November, and that she had brought forth another child one, two, or three months afterwards, of equally full growth, then a case something like superfœtation would have really occurred, and scepticism would have been staggered.” In consequence of the doubts thus expressed by Dr. Granville, the author of the present work, actuated only by a desire after truth, applied to Dr. Maton for a farther explanation of those particular points upon which the merits of the case would seem to turn; and he is thus enabled to clear up the doubts which might be supposed to embarrass its history; the fact is, that both the children were born perfect, the first therefore could not have been a six month’s child; and with respect to the distressing circumstances which attended the delivery, Dr. Granville appears to have fallen into an important error; he speaks of them as having “brought on the premature contraction of the womb, so as to expel part of its contents in November,” whereas upon referring to the particular expressions used by Dr. Maton in the paper alluded to, we shall soon perceive that they by no means support the assumption of the labour having been premature, nor that it was brought on by distressing circumstances; on the contrary, we find upon farther inquiry that the distressing circumstances to which the author alludes were the natural consequence, not the active cause of the labour; indeed the fact, as we learn from Dr. Maton, stood thus,—the lady could not obtain better accommodation at the time; that the labour, although quick, was not sudden, for the accoucheur was already in attendance; and that it was not premature, for the natural period of utero-gestation was supposed to have been completed. We must not omit to state that all the particular circumstances of the case were communicated to Dr. Maton by the husband of the lady, and as he could not have had any particular theory to maintain, or any private interest to serve, there cannot exist any good reason for questioning the veracity of his testimony, or the justness of our conclusions.
Several physiologists who have attempted to explain the cause of superfœtation have supposed that in such cases the uterus is virtually double; Morgagni informs us, that Catti, the Neapolitan anatomist, was the first to observe this phenomenon, and that it is owing to a strong membrane which so divides the uterus, that the mouth of a fallopian tube corresponds with each of its cavities; and he farther states, that this strange structure was found combined with a corresponding division of the vagina; Valisnieri[[426]] also met with a double uterus, and a double vulva; the same malformation has been noticed by Littre,[[427]] Bauhuin,[[428]] Eissenmann,[[429]] Haller,[[430]] and by Rhoederer; this latter physiologist in a letter, from Strasburgh, preserved among the Sloane manuscripts, says, “We have got here a great curiosity, viz. a woman body of eighteen years of age, who has the natural parts externally well formed, but internally two vaginæ, each with its hymen, to which responds also an uterus duplex having two orificia, each of ’em hanging in its proper vagina, that in such a manner there is quite a double system of generation, and if she had been living a superfœtation could have been formed.” Sabbatier says that he believes in the possibility of superfœtation, and that the above formation will explain its occurrence; an opinion which is sanctioned by Gravel[[431]] and Teichmeyer;[[432]] Duffien also observes, “Cette double matrice sert très bien a expliquer la superfœtation.”[[433]] In quadrupeds superfœtation very commonly occurs, and it has been explained by supposing that the uterus of these animals is divided into different cells, and that their ova do not attach themselves to the uterus so early as in the human subject, but are supposed to receive their nourishment for some time by absorption; hence the os uteri does not close immediately after conception; for a bitch will admit a variety of dogs while she is in season, and will bring forth puppies of these different species; thus, it is common for a greyhound to have in the same litter, one of the greyhound kind, a pointer, and a third or more, different from both.[[434]]