195. Each menstruation continues from three to five days; in some for a week; and in others for a longer period. It is estimated that, during each menstruation, from four to six ounces is, on an average, the quantity discharged.
196. A lady seldom conceives unless she be “regular,” although there are cases on record where women have conceived who have never been “unwell;” but such cases are extremely rare.
197. Menstruation in this country usually commences at the ages of from thirteen to sixteen, sometimes earlier; occasionally as early as eleven or twelve; at other times later, and not until a girl be seventeen or eighteen years of age. Menstruation in large towns is supposed to commence at an earlier period than in the country, and earlier in luxurious than in simple life.[[44]]
198. Menstruation continues for thirty, and sometimes even for thirty-five years; and, while it lasts, is a sign that a lady is liable to become pregnant—unless, indeed, menstruation should be protracted much beyond the usual period of time. As a rule, then, when a woman “ceases to be unwell,” she ceases to have a family; therefore, as menstruation usually leaves her at forty-five, it is seldom, after that age, that she has a child.
199. I have known ladies become mothers when they have been upwards of fifty years of age. I myself delivered a woman in her fifty-first year of a fine healthy child. She had a kind and easy labor, and was the mother of a large family, the youngest being at the time twelve years old.[[45]] “Dr. Carpenter, of Durham, tells us that he has attended in their confinements several women whose ages were fifty. ‘I well recollect a case occurring in my father’s practice in 1839, where a woman became a widow at forty-nine years of age. Shortly afterwards she married her second husband, and within twelve months of this time gave birth to her first child. These cases belong to the working classes. But I know of two others, where gentlewomen became mothers at fifty-one with her first child, the other with her eighth. I can say nothing of how they menstruated, but I know of a virgin in whom the catamenia appeared regularly and undiminished up to and at the end of sixty.’ Dr. Powell says that he last year attended a woman in her fifty-second year; and Mr. Heckford, that he attended a woman who stated her age to be at least fifty. Mr. Clarke, of Mold, states that he has attended several women whose ages were upwards of forty-four, and that he lately delivered a woman of her first child at forty-eight. Mr. Bloxham, of Portsmouth, delivered at fifty-two, in her first confinement, a woman who had been married thirty-five years.”[[46]]
200. In very warm climates, such as in Abyssinia and in India, girls menstruate when very young—at ten or eleven years old; indeed, they are sometimes mothers at those ages.[[47]] But when it commences early, it leaves early; so that they are old women at thirty. “Physically, we know that there is a very large latitude of difference in the periods of human maturity, not merely between individual and individual, but also between nation and nation—differences so great that in some southern regions of Asia we hear of matrons at the age of twelve.”[[48]] Dr. Montgomery[[49]] brings forward some interesting cases of early maturity. He says: “Bruce mentions that in Abyssinia he has frequently seen mothers of eleven years of age; and Dunlop witnessed the same in Bengal. Dr. Goodeve, Professor of Midwifery at Calcutta, in reply to a query on the subject, said: ‘The earliest age at which I have known a Hindu woman bear a child is ten years, but I have heard of one at nine.’”
201. In cold climates, such as Russia, women begin to menstruate late in life, frequently not until they are between twenty and thirty years old; and, as it lasts on them thirty or thirty-five years, it is not an unusual occurrence for them to bear children at a very advanced age—even so late as sixty. They are frequently not “regular” oftener than three or four times a year, and when it does occur the menstrual discharge is generally sparing in quantity.
202. The menstrual fluid is not exactly blood, although, both in appearance and in properties, it much resembles it; yet it never in the healthy state clots as blood does. It is a secretion from the womb, and, when healthy, ought to be of a bright-red color, in appearance very much like blood from a recently cut finger.[[50]]
203. The menstrual fluid ought not, as before observed, to clot. If it does, a lady, during menstruation, suffers intense pain; moreover, she seldom conceives until the clotting has ceased. Application must therefore, in such a case, be made to a medical man, who will soon relieve the above painful symptoms, and, by doing so, will probably pave the way to her becoming pregnant.
204. Menstruation ceases entirely in pregnancy, during suckling, and usually both in diseased and in disordered states of the womb. It also ceases in cases of extreme debility, and in severe illness, especially in consumption; indeed, in the latter disease—consumption—it is one of the most unfavorable of the symptoms.