A treatise on the diseases and special hygiene of females

Front matter

OF THE.

U N I VLR.5 ITY Of ILLINOIS

C7ltEm

Dedication

As a text and table book for the student and practitioner, I do not think it has an equal in its department.

As to the materials that I have contributed, I hope you will give your approbation to the notices on the Hsematological Disorders, and also to my remarks upon Puerperal J^ever, concerning which many vague, incompetent and unsettled notions seem to prevail on both sides of the Atlantic. I confess myself as wholly belonging to the party of the Gordons and Heys, who have been so strenuous in their advocacy of a sound pathology and therapeia of the terrible disease in question. You will see that in some places I disagree with M. Colombat, and even enter my protest against his views ; but I can never, even under such circumstances, feel other sentiments than those of a profound respect for an author who has effected so much.

In one of the pages of his Hygiene, M. C. says that women are not, by their nature and position, fitted to shine in the walks of literature, nor to toil for a scientific reputation, which men, even, cannot acquire but at the expense of their health and their happiness. Alas! I am grieved to learn that the estimable author of the Treatise presents, in his own person, the confirmation of his assertion ; and that his ruined health may be traced to the untiring zeal with which he has pursued “ the bubble reputation,” and a more solid advantage, to wit, a consciousness of having done a good work for his day and generation. Join with me in sincere wishes that it may please the Divine Providence to restore his health, and that he may again be able to exert his inexhaustible patience, skill and probity, in behalf of an art which such talents are well qualified to illustrate and adorn.

Introduction

Medicina non ingenii humani partus est,

Sed temporis filia. i Baglivi.

In obedience to the unchangeable law of nature, and in fulfilment of the common destiny of organic beings, the female, like the male, lives under subjection to the various revolutions of existence; like him she is born, grows up, becomes feeble and perishes ; like him she passes through all her phases, and attains the fatal term, after having been constantly under the influences of the varied causes that are capable of affecting the health of the body. But although both sexes are alike exposed to a variety of maladies, the number of ills that overwhelm them, is not alike, for to the too numerous evils which woman participates, as a common lot with man, nature has superadded all those that take their rise in the superior excitability of her nervous system, and in those painful and stormy functions which prepare her for the power, or for the act of reproduction.

If it be true, as Bischat says, that lesions are most frequent in parts where action is greatest, if each organ is liable to be affected in the direct ratio of its degree of activity, there is no occasion for us to be surprised ~at the frequency and variety of the maladies to which the womb is subject. The extreme sensibility of that viscus, its physiological importance, its peculiar irritability, and especially its more or less intimate sympathetic connection with other parts of the body, render it a centre of action, which in the sex seems, in a measure, to domineer over the whole economy, and form the principal basis upon which the edifice of the organization rests. It is easy, from what we have just said, to explain why the vital lesions of the womb and its appendages rarely exhibit themselves at the two extremes of existence, but are very frequent at the season of the cessation of the menses, and especially throughout the whole term of years during which the genital organs are subject to periodical states of excitation, as well as to other excitements of various kinds.

VI

INTRODUCTION.

All these disorders, the number of which Democritus exaggerated in his letter to Hippocrates, in which he says “ Uterus sexcent arum, aerumnarum in mulieribus causa,” all these disorders are much better understood in modern than they were in ancient times. Our ideas in regard to their nature, causes and treatment, are more precise in the present age, because in their search after truth, the medical men of the present period are guided by a more rigorous analysis of symptoms, and have liberated themselves from the rusty chains of the doctrines of the ancients, by embracing the sources of positive knowledge found in the sciences of physics, chemistry, and pathological anatomy.

Notwithstanding the whole circle of diseased conditions is comprised within the domain of medicine, and though it is the bounden duty of the physician to consecrate his studies and meditations to the discovery of prophylactic and therapeutical methods that may serve to prevent them all, or conduct them with greater or less celerity to a radical cure, they cannot all be equally the objects of his profound research; they cannot all alike exercise his talent for investigation ; he must direct his attention especially to those which, like most of the diseases of the womb, indeed, have been imperfectly studied, and are in some sort known only by their disastrous effects.

In spite of the progress of the human mind, and the numerous conquests that have been made in every department of medical science, there is much still to be said, and a great deal to be done, and a brilliant task remains to be fulfilled. Multum rest at adhuc operis, multumque restabit, nee ulli nato post mille saecula, prsecludetur occasio aliquid adjiciendi. Seneca, lib. i. epist. lxiv.

If, on the one hand, we reflect upon the real improvements in the medico-chirurgical therapeutics of the diseases of the womb, which have lately been introduced by the new methods of diagnosis ; and, on the other hand, consider that all the treatises upon diseases of women are in several regards incomplete, or, at least, far from being up to the level of the times, we shall be able to appreciate the usefulness, and even the necessity of a work that may contain,, although within a narrow compass, every thing relating to this interesting subject. It is with the hope of filling up this vacuum, and with the intention of being serviceable, both to practitioners and pupils, that the present treatise is published; a treatise which comprises an account of the physiology, the surgical anatomy, pathology, therapeutics, operative medicine and hygiene, of the genito-mammary organs of the sex.

INTRODUCTION.

Vll

We have been aware of the extent and difficulty of our enterprise. In venturing to undertake it, notwithstanding the numerous difficulties in our path, we have been influenced less by any confidence in our own ability, than by the attraction of the powerful interest of a subject, to which we have, during the last ten years, consecrated a major portion of our studies and researches.'*

The division we have adopted, is founded upon the analogies observed between the maladies whose history is comprised within our plan : with a view to facilitate the study of them, and particularly with the design of grouping and approximating them as closely as possible, in the natural order they ought to occupy in any general system of pathology, we have divided them into six sections, to wit: 1. lesions of form ; 2. lesions of situation; 3. -physical lesions; 4. vital lesions; 5. lesions of the functions; 6. lesions relative to reproduction.

In the first section, which comprises all the primitive and the accidental deformities, we have entered more into detail than any of our predecessors, and endeavoured more distinctly to point out the various lesions connected with the coherence, imperforation, obliteration, narrowness, obturation, and all the different kinds -of genito-urinary occlusion in the female. After relating and criticizing a great number of curious cases, and after having indicated all the diagnostic and therapeutical methods appropriate to these different lesions, we pointed out a very simple mode of perforating the membrana hymen , at the same time preserving it as far as possible, on account of the moral importance attached to its existence, and allowing of a gradual discharge of the menstrual products accumulated within the womb, and avoiding as completely as possible, the pernicious effects of air, when introduced into the cavity of the viscus. We have also proposed a new method of curing congenital narrowness of the vagina, and have given a figure of a cutting thimble, and a knife with a very convex edge, for separating the coherent sides of the vagina.

In the second section we have, in considerable detail, treated of the various prolapsions of the womb ; and founding our opinions upon a great number of observed cases, we have pointed out in a more complete manner, the advantages and disadvantages of the various kinds

* Having been resident surgeon of the Maison de Sante, of the Rue de Valois du Roule, specially appropriated to the medico-chirurgical treatment of the diseases of women; and having, for a long time, attended the learned clinics of Dupuytren, and of Messrs. Lisfranc and Recamier, &c., we have enjoyed opportunities of collecting a great number of cases of disorders of the womb, and its appendages, which we made the subjects of a memoir in the year 1828.

INTRODUCTION.

viii

of pessaries in use, and of other palliative and curative measures scarcely treated of by other authors on the diseases of women. We have, likewise, made efforts to omit nothing important relative to the deviations, the incurvations, the inversion, elevation and immobility of the uterus ; the different hernias of the organ, as well as of the ovaria ; the prolapsus of the lining membrane, and the invagination of the vagina; in fine, the prolapsus and thickening of the lining membrane of the urethra; while the vulvar and vaginal cystoceles and enteroceles have been particularly the objects of our close attention.

In the third section, which comprises all the solutions of continuity, the contusions, the wounds and lacerations ; the ruptures of the vulva, of the perineum* the vagina, and the womb ; the contusions and wounds of the breast, and in fine, the introduction of foreign bodies into the genital cavities, we have proposed various instruments to facilitate and ensure the surgical operations required by these lesions, especially the vaginal fistulas.

In the fourth section, which alone consists of near two hundred pages, and in which are collected the different phlegmasias, acute and chronic, superficial or deep-seated ; the transformations, the degenerations and all the morbid productions of the vulva, the vagina, the uterus, the ovaries and the mammae, we have made known several instruments of our own invention, for the surgical treatment of the polypous tumours and cancerous affections of these organs. For the purpose of facilitating a comparison and impartial judgment of the measures we have proposed, we have mentioned and described with equal fidelity, most of those that have been employed by other medical men ; and we were prevented from giving figures along with the descriptions of the operative proceedings, merely by the consideration that most of them are already of no recent date, and, therefore, generally known.

In the fifth section, not only have we endeavoured to forget nothing relating to the functional lesions and the neuroses peculiar to females, but we have advanced some new ideas on the causes, the diagnosis and treatment of uterine haemorrhage, amenorrhoea, chlorosis, nymphomania and hysteria.

We pass in silence by the sixth section, which figures in our synoptical table of the diseases of women, because it comprises those lesions that are relative to reproduction, which do not enter into the plan of the present work, and which, moreover, are of sufficient importance to induce us to consecrate to them a special Treatise, wholly independent of the present one.

INTRODUCTION.

IX

To complete our prefatory sketch of the plan of this volume, let us remark, that previously to entering properly upon our task, we have given, 1. Four chapters, comprising the history of the physical, moral and physiological changes that occur in women at different periods of life. 2. The varieties of conformation; the surgical anatomy of the sexual organs, and the sympathies of the womb. 3. The different methods of exploration of the genitalia, and the history of the speculum uteri. 4. The general causes and a synoptical table of the diseases of females. It should be likewise observed, that our anatomical and physiological details are confined to considerations applicable directly to pathology and therapeutics. Under the conviction that all epochs and all nations are tributary to medicine, and that to shut up this noble science within the narrow boundaries of an age -or a nation, is to do it injustice, we have neglected none of the materials furnished by antiquity, by the middle ages, and by cotemporary medicine of all countries. It will be perceived, that in stating a variety of opinions, of experiments, and of curious cases, scattered throughout many volumes, numerous collections, and French and foreign journals, we have scrupulously quoted the sources whence they were obtained.* Lastly, in order to render our work as complete as possible, we have brought it to a conclusion by a long chapter on the special hygiene of the female ; and hoping thereby to secure the better attention of the reader, and especially to lessen the dryness of the descriptions, we have intercalated throughout the whole extent of the work, historical facts and many curious and interesting cases.

Notwithstanding all our efforts to succeed and leave no gap unoccupied, we are far from supposing this treatise to be equal to our wishes : that is to say, a *book in which nothing is wanting ; where nothing is in excess ; and where every thing is in its proper place. Should a benevolent criticism point out the errors and omissions of our work, we shall be flattered by it, and shall the more gratefully receive the advice of the learned, especially as we are resolved to profit by any good counsel, even should it be dictated by envy, supposing us sufficiently fortunate to awaken such a feeling.

May our intentions be properly estimated, and may this work obtain the approbation of our readers !

* The extent of our researches will be understood when it is known that we have cited above one thousand authors, an alphabetical list of whom is given, with a view to facilitate the history and literary study of the diseases of women.

-i

.

.

* t

*

Dedication, - - - - - - - -iii

Introduction, --------- y

Chapter I. History Of The Physical, Moral And Physiological Changes Which Take

PLACE IN FEMALES AT THE PRINCIPAL EPOCHS OF LIFE. 17

Phenomena of Gestation, ------ 35

Chapter II

OF VARIETIES OF CONFORMATION, THE SURGICAL ANATOMY OF THE GENITAL ORGANS,

AND THE SYMPATHIES OF THE WOMB. 43

Of the Vagina and certain varieties of Conformation observed in it, - - 46

Of the Womb; its Surgical relations, and certain Varieties of its situation, - 49 Varieties of Conformation, and surgical relations of the Neck of the Womb, 51

Faulty Conformation, primitive or accidental, of the Female Sexual Organs, - 53 Of the Sympathies of the Womb, - - - - - - 56

Chapter III

EXAMINATION OF THE FEMALE ORGANS OF GENERATION, BY TOUCHING AND BY THE . SPECULUM.

Of Touching per Vaginam, ------- 60

Of Touching by the Rectum, -------62

Of Palpation above the Pubis, or Touching at the Hypogastrium, - - 63

Of the Speculum Uteri and the manner of using it, - - - - 64

Chapter IV. General Causes And Synoptical Table Of Diseases Of Females. 71

Xll

Contents

. FIRST SECTION.

CHAPTER V. Lesions of Form and Development, ------ 74

Occlusion of the Sexual Organs, - - - - - 74

Of the Union of the Labia and of other faulty Conformations of the Vulva

and its parts, - - - - - - - - 76

Of Cohesion of the Nymphee, ------- 79

Of Excessive Development of the Nvmphse, ----- 80

Of Unnatural Development of the Clitoris, and of its Excision, - - 82

Imperforation and Stricture of the Female Urethra, - - - 85

Faulty Conformation of tfce Vagina, ------ 87

Of Congenital Narrowness of the Vagina, - - - - - 94

Of Accidental Obliteration and Stricture of the Vagina, ... 100

Of Obturation of the Vagina and the Means of cure, - - - - 106

Surgical Treatment of Accidental Cohesion of the Vaginal Parietes; and of

Congenital Obturation of the Vagina, - - - - - 111

Occlusion of the Cervix Uteri, - - - - - - -113

Atresia of the Fallopian Tubes, - - - - - -115

Of Absence of the Vagina — and of Cases in which the Vagina opens into the

Rectum or Bladder, - - - - - - - 116

Absence of the Womb and Means by which it can be ascertained, - - 118

SECOND SECTION.

CHAPTER VI. Lesions of Situation, - ------ - 121

Of Hysteroptosis, - - - - - - - -122

Of Pessaries and their Varieties, - - - - - - 133

Of the principal Pessaries in use, and the Method of Employing them, - 139

Of the choice of a Pessary, - - - - - - -145

Accidents connected with the presence of a Pessary in the Vagina, - - 145

Complications contra-indicating the use of the Pessary, and Indications in

certain peculiar cases, - 149

Cure of Prolapsus Uteri, ------- 150

Extirpation of the Prolapsed Womb, ------ 152

Method of Operating, - - - - - ... -152

Of Anteversion and Retroversion of the Womb, - - - - 154

Of the Anteflexion and Retroflexion or Curvature of the Uterus, - - 169

Of Inclination, and Obliquity of the Womb, - 172

Of Inversion of the Womb, - - - - . . -175

Of Elevation of the Womb, - - - - . . -190

Of Abnormal Immobility of the Womb, ----- 191

Of Hysterocele or Hernia of the Womb, - - - - - 194

Inguinal Hysterocele, -------- 195

Crural Hysterocele, - - - . - . - - 195

CONTENTS. Xlll

Ventral Hysterocele, - - - - - - - -196

Vaginal Cystocele, or Hernia of the Bladder in the Vagina, - - - 201

Prolapsion of the Mucous Membrane of the Urethra, - 204

Vulvar Enterocele and Cystocele, - - - - - 208

Of Inversion and Swelling of the Lining Membrane of the Vagina, - - 209

Invagination of the Vagina, ------- 214

THIRD SECTION.

CHAPTER VII. Physical Lesions, - -- -- -- - 215

Contusion of the Labia Majora, - - - - - - 216

Of Rupture of the Perineum and the Means of remedying it, - - - 217

Of Lacerations and of Rupture of the Vagina, .... 224

Of Contusions and Wounds of the Uterus, ----- 227

Contusions and Wounds of the Mammae, ----- 229

Of Rupture of the Uterus, ------- 230

Of Vaginal Fistulas, - -- -- -- - 238

Of Vesico-Vaginal and Recto-Vaginal Fistulas, - - - - 238

Of the Palliative Method, ------- 243

Temporary Palliative Method, ------- 244

Of Tamponnement, and of Dessault’s Method, ... - 245

Of Cauterization, -------- 246

Of the Suture, 249

Method of the Author, ------- - 252

Of the Approximation of the Edges of Vagino-Vesical Fistulas by means of

peculiar instruments, without the use of the Suture, - - - 257

Of Recto-Vaginal Fistulas, - - - - - - -261

A Recto-Vaginal Fistula, cured by J. Rhea Barton, M.D., - - - 264

Of Foreign Bodies accidentally introduced into the Vagina, the Uterus and

the Canal of the Urethra, ------ 266

FOURTH SECTION.

CHAPTER VIII. Vital and Organic Lesions, ------- 268

Superficial Inflammation of the Vulva, ----- 269 ^

Of Prurigo of the Vulva, ------- 269

Of Phlegmon and deep-seated Inflammation of the Labia Majora, - - 272

Gangrenous Inflammation of the Labia Majora, - - - 273

Acute Inflammation of the Vagina, ------ 274

Inflammation of the Parenchyma and Lining Membrane of the Uterus, - 276

Treatment of Acute Metritis, ------- 284

Of Chronic Metritis or Subacute Inflammation of the Proper Tissue of the

Chronic Metritis without Engorgement, ----- 294

XIV

CONTENTS.

Chronic Metritis with Engorgement, ------ 295

Engorgement of the Uterus without Induration, ... - 297

Of CEdema of the Neck of the Uterus, ----- 299

Sanguine Engorgement of the Uterus with or without Haemorrhage, - - 300

Congestive Engorgement with Haemorrhage, ----- 301

Of Primary Engorgement with Induration, ----- 303

Of Scirrhous Engorgement, ------- 304

Tubercular Induration, - 305

Of Leucorrhoea, or the Whites, ------ 307

Of Redness, Simple Ulcerations, and Eruptions upon the Os Tincae, - - 323

Of Chancres, and Scrofulous Ulcers, etc., upon the Os Tincae, - - 325

Of Carcinomatous Ulcers, ------- 327

Of Cancer of the Uterus, ------- 328

Surgical Treatment of Cancer, ...... 344

Amputation of the Neck of the Uterus, ----- 346

Modifications of the Operation by the Author, ... - 349

Of Hysterotomy performed without displacing the Uterus, - - - 351

Description of the Operation, ------- 352

Advantages of the Author’s Method, ------ 356

After-Treatment, - 358

Extirpation of the Cancerous Uterus, ------ 360

Physometra, or Tympanitis of the Womb, ----- 366

Of Hydrometra, or Dropsy of the Womb, ----- 374

Of Hydatids of the Womb, - - - - - - £ - 373

Of Calculi of the Womb, and other Genital Parts, ... - 381

Of Polypus of the Womb and Vagina, ----- 385

Inflammation of the Ovaria and Fallopian Tubes, - - - - 410

Of Dropsy of the Ovaries, and Fallopian Tubes, ... - 420

Of Cancer of the Ovarium and other Degenerations of that organ, - - 433

Cancer of the Vagina and external Organs of Generation, - - - 437

Of CEdema, Varix, and other Tumours of the Vulva, - - - - 438

Of Encysted Tumours, and different kinds of Chronic Engorgement of the

FIFTH SECTION.

CHAPTER IX. Lesions of the Functions, ------ 459

Of Amenorrhoea, - -- -- -- - 463

'Of Dysmenorrhcea, -------- 479

Of Immoderate Flow of the Menses and other Uterine Haemorrhages, - 483

Of Metrorrhagia, - - - - - - ... 486

Of Chlorosis or Green Sickness, ------ 495

Of Nymphomania, or Furor Uterinus, ------ 513

Of Hysteria and other Spasmodic Diseases of Women, ... 518

Hysteriform Attacks, - - - - - - - 536

Of Gastro-Intestinal Spasm, ------- 538

Of Hysteralgia, -------- 540

CONTENTS.

XV

CHAPTER X. Special Hygiene of Women, - 542

Hygienic Rules concerning Puberty and Menstruation, - - - 552

Hygienic Rules in relation to the Union of the Sexes, ... 546

Hygienic Rules relative to the Change of Life, - • - 549

General Hygiene of Women, ------- 552

SIXTH SECTION.

CHAPTER XI. Lesions relative to Reproduction, ------ 562

Of Impotence and Sterility, ------- 562

Of False Pregnancy, -------- 568

Of Moles, or Depraved Conception, ------ 570

Of Extra-Uterine Pregnancy, ------- 574

Of Diseases connected with Pregnancy, ----- 584

Of Abortion or Miscarriage, ------- 585

Of Nausea and Vomiting, ------- 595

Of Dyspepsia and Polydipsia, ------- 600

Of Capricious Appetite, (Pica, Malacia,) ----- 600

Of Pyrosis, Dysphagia and Heartburn, - - - - - 601

Of Constipation, - -- -- -- - 604

Of Diarrhoea, Dysentery and Tenesmus, ----- 605

Of Cough, 609

Of Haemorrhages occurring during Pregnancy, - 610

Of Haemoptysis, Haernatemesis and Epistaxis, - - - 616

Disorders of the Circulation during Pregnancy, - - - 61 S

Of Palpitation, - - - - - - - - - 619

Of Haemorrhoids, -------- 624

Of Cephalalgia and Vertigo, 627

Insomnia, or Agrypnia, -------- 628

Lesions of the Sight, the Hearing, the Smell, &c., - 629

Disorders of the Intelligence and of the Moral Inclinations and Affections, - 631

Of Eclampsia, or Puerperal Convulsions, ----- 632

Disposition to Fall, - 646

Disorders of the Urinary Organs during Gestation, ... - 647

Pains in different parts during Pregnancy, ----- 648

XVI

CONTENTS.

Diseases connected with the Lying-in, - After-Pains, -

Accidents relative to the Lochia, - Of Milk-Fever, ------

Of Puerperal Peritonitis, -

Of Uterine Phlebitis, - - - - -

Of other kinds of Puerperal Phlebitis,

Of Painful (Edema, - - - -

Puerperal Neuritis, -

Of Phlegmonous Abscess in Lying-in Women,

Inertia of the Womb, and Flooding depending thereon,

Of Miliary Eruption, - - - - -

Lesions relative to Lactation, -

Polygalactia, and Milk-Consumption, -

Diseases of the Mammae, -

Of Inflammation of the Mammae, or the Weed,

Hygiene of Pregnant and Lying-In Women,

List of Authors, - Ihdex,

A

TREATISE

OX THE

DISEASES OF FEMALES.

Chapter I

HISTORY OF THE PHYSICAL, MORAL AND PHYSIOLOGICAL CHANGES WHICH TAKE PLACE IX FEMALES AT THE PRINCIPAL EPOCHS OF LIFE*

Feeble and sensitive at birth, and destined by nature to give us existence and to preserve us afterwards by means of her tender and watchful care, woman, the most faithful companion of man, may be regarded as the very complement of the benefits bestowed upon us by the Divine Being ; as an object fitted to excite our highest interest, and presenting to the philosopher, as well as to the physician, a vast field of contemplation.

What subject, indeed, is more worthy of our attentive meditation than the ‘series of changes, physical, moral and physiological, that accompany every stage of woman’s existence ! By a long succession of modifications and revolutions, she discloses all the phases of her constitution. In infancy she differs slightly from the male, in whose pleasures and amusements she participates, as well as in his dispositions and tastes, his inconstancy and vivacity. At that early period, ignorant of her own sex, ignorant, so to speak, of her own nature, the blush of modesty does not mantle on her cheek, and her eyes, which reveal no passions, seem to seek only what has reference to her real wants.

Although at this early epoch her body is but a sketch of the forms it is destined to assume at a later period, she always retains, even after her entire development, some touch of the softness and delicacy peculiar to childhood, and does not depart so widely as her playmate from the idea of her original constitution.

The reproductive faculty divides the life of the female into three very distinct periods or stages. In the first, this property has no existence*, in the second it is in fpll activity, and in the third it has become null again. The duration of the first commonly decides that 2

IS

PHENOMENA OF PUBERTY.

of the two last periods; so as to establish the general rule that the old age of woman comes earlier in proportion as her puberty has been more precocious.

The vital forces that regulate the organic system, and the organs that constitute that system, gradually increase during the first period of life; they attain their perfect development in the second ; and diminish and become extinct at the close of the third, whose term, like that of the others, may be accelerated or retarded by different accidental causes and circumstances, dependent on certain physical and moral conditions.

Upon setting out in the career of life, the two sexes exhibit nearly the same physiognomical characters and the same delicacy of organization. Their type and their character, as yet indeterminate, differ only by almost imperceptible modifications, and which it is not possible to trace out in full detail. Subject to the same functions and wants, their isolated and individual existence fails, as yet, to reveal the sympathetic relations that are in the end destined to establish between them a state of reciprocal dependence. Subjects of the same kinds of diseases, they are principally liable to the convulsive affections, and especially to inflammation of the brain, because the head, which, in infancy, has a proportional size greater than in any other age, is, in them a vital centre, towards which almost all the efforts of the organisms are directed.

The shades of difference in the sexes soon assume a more decided tone; and their peculiar characters become so much the more marked as the development of each individual is more complete and approaches more nearly to the period when, by a sudden change, nature reveals the completion of those preparations she has been silently making.

The interval betwixt the tenth year and the age of puberty is a period of transition, a sort of passage from childhood to adolescence, which appears to be the happiest era in the life of the female. Her extreme nervous mobility prevents her being too long impressed by the grave sentiments that might be fitted to interfere with her happiness. This being for young women the period of gentle pleasures and of the freest gaiety, it follows that imagination exhibits every object under the most attractive colours, and that the existence of young females is agreeably varied by a piquant freedom of action and a great mobility of tastes and affections. Exempt, at this age, from cares and troubles, they sing, they weep and laugh at the same moment; and, as their joys, so their pleasures and their grief, as well as all their other impressions, are ephemeral; they proceed along a flowery path up to the age when nature calls on them for the tribute which they owe to the species.

The young girl who, until now, was an equivocal, non-sexual creature, becomes a woman in her countenance and in all the parts of her body, in the elegance of her stature and beauty of her form, the delicacy of her features, in her constitution, in the sonorous and melodious tones of her voice, in her sensibility and affections, in her character, her inclinations, her tastes, her habits and even in her

PHENOMENA OF PUBERTY.

maladies. Very soon are all the traits of resemblance between the two sexes found to be effaced. The bud newly expanded blossoms amongst the flowers, and this brilliant metamorphosis is signalized by the rosy tints of the cheeks and lips, and the perfect development which discloses the arrival of the age of puberty.