A treatise on the science and practice of midwifery / By W. S. Playfair.
- William Smoult Playfair
- Date:
- 1885
Licence: Public Domain Mark
Credit: A treatise on the science and practice of midwifery / By W. S. Playfair. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
103/708 page 93
![strual nisus, although the amount of blood lost is much less than in ordinary menst ruation. Cessation of Menstruation.—After a certain time changes occur, show- ing that the woman is no longer fitted for reproduction; menstruation ceases, Graafian follicles are no longer matured, and the ovary becomes shrivelled and wrinkled on its surface. Analogous alterations take place in the uterus and its appendages. The Fallopian tubes atrophy, and are not unfrequently obliterated. The uterus decreases in size. The cervix undergoes a remarkable change, which is readily detected on vaginal examination; the proiection of the cervix into the vaginal canal disappears, and the orifice of the os uteri in old women is found to be flush with thejiiofof the vagina, in a large number of cases there is, after the cessation of menstruation, an occlusion both of the external and internal os; the canal of the cervix between them, however, remains patulous, and is not unfrequently distended with a mucous secretion. Period of Cessation.—The age at which menstruation ceases varies much in different women. In certain cases it may cease at an unusually early age, as between 30 and 40 years, or it may continue far beyond the average time, even up to 60 years; and exceptional, though perhaps hardly reliable, instances are recorded in which it has continued even to 80 or 90 years. These arS, however, strange anomalies, which, like cases of unusually precocious menstruation, cannot be considered as hav- ing any bearing on the general rule. Most cases of so-called protracted menstruation will be found to be really morbid losses of blood depend- ing on malignant or other forms of organic disease, the existence of which, under such circumstances, should always be suspected. In tliis country menstruation usually ceases between 40 and 50 years of age! Raciborski says that the largest number of cases of cessation are met with in the 46th year. It is generally said that women who commence to menstruate when very young cease to do so at a compara- tively early age, so that the average duration of the function is about the same in all women. Cazeaux and Raciborski, whose opinion is strengthened by the observations of Guy in 1500 cases,^ think, on the contrary, that the earlier menstruation commences the longer it lasts, early menstruation indicating an excess of vital energy which continues during the whole childbearing life. Climate and other accidental causes do not seem to have as much effect on the cessation as on the establish- ment of the function. It does not appear to cease earlier in warm than in temperate climates. The change of life is generally indicated_by irregularities in the recurrence of the discharge. It seldom ceases sud- denly, l)ut it may be absent for one or more periods, and then occur irregularly; or it may become profuse or scanty, until eventually it entirely stops. The popular notions as to the extreme danger of the menopause are probably nnicli exaggerated, although it is certain that at tliat time various nervous phenomena are apt to be developed. So far from having a ])r(;judicial effect on the health, however, it is not an un- common o])servation to see an hysterical woman, wlio has been for years a martyr to uteriiK; and other coiiiplaints, apparently take a new lease of life when her uterine functions have ceased to be in active operation; ' Mtd. Times and Guz., 1845.](https://iiif.wellcomecollection.org/image/b2121072x_0103.jp2/full/800%2C/0/default.jpg)
