of the nervous system has in some cases amounted to coma and lethargy.

Having thus briefly sketched the varied phenomena which attend on the successive stages of the reproductive function, I am able to open the investigation of its terminal crisis.

To ascertain the date of cessation is a point of great importance, for it often marks the climax of much previous and subsequent suffering. In the following table I have placed side by side, the results obtained in Paris by B. de Boismont, and in London by Dr. Guy and myself. It will be seen that although the date of cessation varies from the twenty-first to the sixty-first year, yet it may generally be expected from forty to fifty. Thus, out of B. de Boismont's 181 cases, in 114 cessation took place between forty and fifty inclusively; in 330 of my 500 cases, cessation occurred during the same decennial period; and out of Professor Hannover's 312 cases of cessation in Denmark, 250 occurred during the same period of time.

TABLE I.-Dates of the CESSATION of Menstruation.

Sources of

Information.

It will be noticed that the average date of cessation is higher in proportion to the amount of cases, that the average of the 1082 cases is forty-five years nine months, and that more women cease to menstruate in the fiftieth year than in any other, which is confirmed by Mayer's experience at Berlin, and by that of Lieven, at St. Petersburg.

What is known of the cessation date of menstruation is shown by the following table:

Observers

de Bois- Leudet. Tilt.

head.

Mayer.

ver.

mont.

Vogt.

This Work.

On Abortion

and Sterility.

Paris Medical

Congress.

Work on
Menstruation.

It is difficult to understand why there should be a difference

of nearly five years between the dates of cessation of 312 Danish and 391 Norwegian women, but the similarity of results obtained by Professor Faye and Dr. Vogt should suggest to my friend Dr. Hannover to test the date of the ménopause in Denmark, by more extended figures.

There is nothing positively known respecting the date of cessation in tropical climates. Are we to believe the Hindoo medical student, who, out of his own circle of acquaintance, gave Dr. Webb* a list of thirteen Hindoo women in whom cessation occurred at the following very late dates?

"Pathologica Indica," Part II, p. 279.

I could not match this list, from amidst those who consult me, nevertheless, a comparatively late date of cessation in India is rendered probable by the fact that Hindoo legislators place the ménopause at fifty, and in the Koran, women are only considered too old to have children after the fifty-third year of their age.

Having thus established the average age of cessation, the frequent exceptions to the rule remain to be considered, bearing in mind that it may be taken for granted that late fecundity proves late menstruation. Twice have I known the menstrual flow to continue its regular appearance up to the sixty-first year, in ladies of a remarkably strong constitution: which was the case with a lady who regularly menstruated up to the time of her death in her eighty-fourth year.

Mr. Roberton observes:-"I am able to speak confidently concerning three women who had children at advanced ages,— one in her fiftieth year, another in her fifty-first, and the third in her fifty-third year. In each of these instances the menstrua continued up to the period of conception." He also cites a case where menstruation ceased for twelve months about the fiftieth year, when it again became regular and continued so until the seventieth. Mr. Davies, my colleague at the Farringdon Dispensary, has confined a lady of her thirteenth child, at the age of fifty-three, after which there was no menstrual flow; and Dr. Davies published the case of a woman who was fifty-five when her last child was born, and who menstruated up to conception; and Dr. Meyer, of Berlin, in his remarkable paper* mentions his having ascertained that out of 6000 women, menstruation was still progressing in twentyeight at the age of fifty, in eighteen at fifty-one, in eighteen at

* Congrés Médical International de Paris.

fifty-two, in eleven at fifty-three, in thirteen at fifty-four, in five at fifty-five, in four at fifty-six, in three at fifty-seven, in three at fifty-eight, in one at fifty-nine, in four at sixty, in four at sixty-two, and in three at the age of sixty-four, the seven last cases occurring in the upper classes. These unusually protracted dates make it appear singular that Hannover should have observed nothing similar in Denmark, for he only notes the exceptional occurrence of cessation in one case at fifty, two at fifty-one, three at fifty-two, one at fifty-three, and one at fifty-four.

Dr. Marion Sims has met with two cases of parturition at fifty-two, and a negro woman was said to be sixty, when she was confined twenty years after her last confinement.

Lamotte relates that a woman had thirty-two children, and menstruated quite regularly up to her sixty-second year. Auber attended two women, one sixty-eight and the other eighty, who for the last few years had again menstruated. The flow came regularly, lasted three or four days, and during that time they were more nervous than usual, the organs of sensation being unusually dull in apprehending their appropriate stimuli. Saxonia states that a nun, in whom the menstrual flow ceased at the usual time, experienced its return when her 100th year was attained, and it continued regular until her death, three years after. Rush mentions the case of a woman who was confined for the last time in her sixtieth year, menstruated until her eightieth, and died in her 100th year.

Haller records two cases in which women at sixty-three and seventy respectively bore children. Capuron cites the case of a lady, who after the menstrual flow had been absent for several years, saw it return at sixty-five. Three months after she miscarried, the foetus being well formed. Meissner states that a woman who first menstruated at twenty, bore her first child at forty-seven, and the last of seven other children at sixty. Menstruation ceased and reappeared at seventy-five, continuing until ninety-eight, then stopped for five years, again to return at the advanced age of 104. In 1812 she was still alive.

I might increase the number of such cases, which are not instances of irregular flooding, but of the menstrual flow, oc