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menstrual periods； any more than he would make the diagnosis of pregnancy from the fact of the suppression of menses。 Blake reports an instance of catamenia and mammary secretion during pregnancy。 Denaux de Breyne mentions a similar case。 The child was born by a face…presentation。 De Saint…Moulin cites an instance of the persistence of menstruation during pregnancy in a woman of twenty…four； who had never been regular； the child was born at term。 Gelly speaks of a case in which menstruation continued until the third month of pregnancy； when abortion occurred。 Post； in describing the birth of a two…pound child； mentions that menstruation had persisted during the mother's pregnancy。 Rousset reports a peculiar case in which menstruation appeared during the last four months of pregnancy。
There are some cases on record of child…bearing after the menopause； as； for instance； that of Pearson； of a woman who had given birth to nine children up to September； 1836； after this the menses appeared only slightly until July； 1838； when they ceased entirely。 A year and a half after this she was delivered of her tenth child。 Other cases； somewhat similar； will be found under the discussion of late conception。
Precocious menstruation is seen from birth to nine or ten years。 Of course； menstruation before the third or fourth year is extremely rare； most of the cases reported before this age being merely accidental sanguineous discharges from the genitals； not regularly periodical； and not true catamenia。 However； there are many authentic cases of infantile menstruation on record； which were generally associated with precocious development in other parts as well。 Billard says that the source of infantile menstruation is the lining membrane of the uterus； but Camerer explains it as due to ligature of the umbilical cord before the circulation in the pulmonary vessels is thoroughly established。 In the consideration of this subject； we must bear in mind the influence of climate and locality on the time of the appearance of menstruation。 In the southern countries； girls arrive at maturity at an earlier age than their sisters of the north。 Medical reports from India show early puberty of the females of that country。 Campbell remarks that girls attain the age of puberty at twelve in Siam； while； on the contrary； some observers report the fact that menstruation does not appear in the Esquimaux women until the age of twenty…three； and then is very scanty； and is only present in the summer months。
Cases of menstruation commencing within a few days after birth and exhibiting periodical recurrence are spoken of by Penada； Neues Hannoverisehes Magazin； Drummond； Buxtorf； Arnold； The Lancet； and the British Medical Journal。
Cecil relates an instance of menstruation on the sixth day； continuing for five days； in which six or eight drams of blood were lost。 Peeples cites an instance in Texas in an infant at the age of five days； which was associated with a remarkable development of the genital organs and breasts。 Van Swieten offers an example at the first month； the British Medical Journal at the second month； Conarmond at the third month。 Ysabel； a young slave girl belonging to Don Carlos Pedro of Havana； began to menstruate soon after birth； and at the first year was regular in this function。 At birth her mamma were well developed and her axillae were slightly covered with hair。 At the age of thirty…two months she was three feet ten inches tall； and her genitals and mammae resembled those of a girl of thirteen。 Her voice was grave and sonorous； her moral inclinations were not known。 Deever records an instance of a child two years and seven months old who； with the exception of three months only； had menstruated regularly since the fourth month。 Harle speaks of a child； the youngest of three girls； who had a bloody discharge at the age of five months which lasted three days and recurred every month until the child was weaned at the tenth month。 At the eleventh month it returned and continued periodically until death； occasioned by diarrhea at the fourteenth month。 The necropsy showed a uterus 1 5/8 inches long； the lips of which were congested； the left ovary was twice the size of the right； but displayed nothing strikingly abnormal。 Baillot and the British Medical Journal cite instances of menstruation at the fourth month。 A case is on record of an infant who menstruated at the age of six months； and whose menses returned on the twenty…eighth day exactly。 Clark； Wall； and the Lancet give descriptions of cases at the ninth month。 Naegele has seen a case at the eighteenth month； and Schmidt and Colly in the second year。 Another case is that of a child； nineteen months old； whose breasts and external genitals were fully developed； although the child had shown no sexual desire； and did not exceed other children of the same age in intellectual development。 This prodigy was symmetrically formed and of pleasant appearance。 Warner speaks of Sophie Gantz； of Jewish parentage； born in Cincinnati； July 27； 1865； whose menses began at the twenty…third month and had continued regularly up to the time of reporting。 At the age of three years and six months she was 38 inches tall； 38 pounds in weight； and her girth at the hip was 33 1/2 inches。 The pelvis was broad and well shaped； and measured 10 1/2 inches from the anterior surface of the spinous process of one ilium to that of the other； being a little more than the standard pelvis of Churchill； and； in consequence of this pelvic development； her legs were bowed。 The mammae and labia had all the appearance of established puberty； and the pubes and axillae were covered with hair。 She was lady…like and maidenly in her demeanor； without unnatural constraint or effrontery。 A case somewhat similar； though the patient had the appearance of a little old woman； was a child of three whose breasts were as well developed as in a girl of twenty； and whose sexual organs resembled those of a girl at puberty。 She had menstruated regularly since the age of two years。 Woodruff describes a child who began to menstruate at two years of age and continued regularly thereafter。 At the age of six years she was still menstruating； and exhibited beginning signs of puberty。 She was 118 cm。 tall； her breasts were developed； and she had hair on the mons veneris。 Van der Veer mentions an infant who began menstruating at the early age of four months and had continued regularly for over two years。 She had the features and development of a child ten or twelve years old。 The external labia and the vulva in all its parts were well formed； and the mons veneris was covered with a full growth of hair。 Sir Astley Cooper； Mandelshof； the Ephemerides； Rause； Geoffroy…Saint…Hilaire； and several others a report instances of menstruation occurring at three years of age。 Le Beau describes an infant prodigy who was born with the mammae well formed and as much hair on the mons veneris as a girl of thirteen or fourteen。 She menstruated at three and continued to do so regularly； the flow lasting four days and being copious。 At the age of four years and five months she was 42 1/2 inches tall； her features were regular； the complexion rosy； the hair chestnut； t