Part 3

Another matter which disturbs the woman at this time, in many cases, is the common belief that after "the change" she will lose all of her sex attractiveness, and her sexual feelings, etc. This is a grave error, for the experience of all observing physicians is that no such results follow this period of the woman's life. Many women become even more attractive to the other sex after this time, by reason of acquiring a certain maturity and "ripeness" which proves very attractive to many men--often to young men as well as older ones. Moreover, the sexual desires do not cease with the cessation of the reproductive functions. On the contrary, it often happens that such emotions and desires are increased in the woman at, and after, this time of her life. So true is this that this period has been called "The Dangerous Age" for women, and the experience of many a woman of forty-five to fifty will corroborate this statement. The woman at this time should beware of contracting unwise love affairs and entanglements, and of yielding to impulses toward men other than her mate. A word to the wise should be sufficient in this case.

To return to the main subject of Menstruation, it may be said that the monthly flow, when once established, occurs at intervals of every twenty-eight days, on the average, although in some individual cases it occurs as often as every twenty-one days, while in others it occurs as seldom as once in every six weeks, all without exceeding the bounds of normal functioning. Menstruation ceases temporarily during pregnancy, in normal cases, and often also ceases during the period of lactation or nursing. The menstrual period lasts on an average for four or five days, the flow increasing for the first half of the period, and decreasing during the last half. At the beginning of the period there is often manifested a general congestion of all of the sexual organs of the woman, and often of the breasts as well. There is also usually found a sense of physical discomfort, from which more or less irritable feeling arises. In rare cases there are found severe cramps and pains, and in some cases the woman finds it necessary to call in medical aid, or to go to bed, or both. In such cases a cure is often worked by improving the general health, and by observing common sense hygienic rules.

Menstruation is caused by a hypertrophy of the mucus membrane of inner surface of the Uterus, which is followed by a shedding of the hypertrophied membrane. This leaves exposed the underlying vessels, which bleed. New mucus membrane is formed after the period. The menstrual flow consists of a thin, bloody fluid, having peculiar odor, in which is combined blood, thin skin, and mucus membrane, and also mucus from the Uterus and the Vagina, the blood being light in consistency and not clotted.

During the menstrual period the ovum, or egg, is discharged, and enters the Uterus, as we shall see presently.

THE LIFE-HISTORY OF THE OVUM. The physiology of the remaining sexual organs of the woman may perhaps best be studied by considering the story of the Life-History of the Ovum, or human egg, for the functions of such organs are concerned with such life-history of the egg, and really exist merely to create such a history, or rather, to produce the process which constitutes the basis of such history.

The ovum, or egg, when discharged from the ovary, is at first surrounded by a few cells which serve as nourishment, but which soon disappear. It enters the Fallopian Tube and begins its journey toward the Uterus, being urged on its way by the constant movement of the lining-cells of the interior of the tube, in the direction of the Uterus. Certain changes in structure occur. Its passage to the Uterus may be interrupted, and the ovum lost and finally cast off. But the ovum that is successful finally arrives at the Uterus where it awaits impregnation or fertilization by the spermatozoon of the male.

If copulation occurs within a reasonable time after the arrival of the ovum, it is impregnated or fertilized. Fecundation results and conception ensues, the ovum then remaining attached to the walls of the Uterus, and in time develops into the foetus. If, however, the ovum is not impregnated, because of absence of copulation or from other causes, it gradually loses its vitality, and is finally cast off with the several uterine secretions.

It should be explained here that the "spermatozoon" of the male (the plural of the term is "spermatozoa") is the male generative "seed." The sperum, semen, or seminal fluid of the male is filled with hundreds of thousands of spermatozoa. Each spermatozoon is a minute living, moving creature, resembling a microscopic tadpole. It has a head, a rod-like body, and a thin hair-like tail, the latter being kept in constant motion from side to side, by means of which the tiny creature is enabled to travel rapidly from one point to another. The human spermatozoon measures about one six-hundredth of an inch in length. It is composed of protoplasm, the substance of which all living creatures are composed. The spermatozoa are believed to be developed from a parent sperm-cell, by the process of segmentation or subdivision, which process is common to all cell-life. The numerous spermatozoa dwell in a gelatinous substance, which, mingling with the other fluidic secretions of the glands of the male, constitutes the male seminal fluid, sperm, or semen, which is ejaculated by the male during the process of copulation.

Fecundation (i. e. fertilization, impregnation; the process by which the male reproductive element is brought in contact with the female ovum or egg) is brought about by the blending of the male reproductive element (or spermatozoon) with the female reproductive element (or ovum, or egg). This blending is of course accomplished by the bringing together in mutual contact the two reproductive elements just mentioned. The sexual act which results in this "bringing together" of the two elements is known as "copulation," or "coition." In copulation or coition the seminal fluid of the male, containing an enormous number of spermatozoa, is ejaculated from the male intromittent organ into the receptive canal or channel of the female (the Vagina), and in this way finally comes into actual contact with the female ovum or egg which is awaiting it in the Uterus of the female.

The spermatozoa (in the process of copulation) are deposited in the Vagina of the female, usually at its upper end, but sometimes in the lower portion; and in rare and peculiar cases even at or about the Vaginal Orifice or outer vaginal opening. In either case they travel up the remaining portion of the Vagina and finally enter the Uterus or womb. The spermatozoa possess wonderful vitality and power of locomotion. There are cases recorded in which the spermatozoa deposited on or about the outer female genitals have managed to travel inward and upward until they have finally reached the Uterus, where conception has resulted. Such cases, of course, are rare, but they exist, well authenticated and accepted by medical science as facts.

It must not be supposed, however, that the impregnation of the ovum occurs only in the womb proper. Cases are known in which the spermatozoa have traveled along the Fallopian Tubes and impregnated the ovum there; and in very rare cases the spermatozoon seems to have penetrated even to the Ovary itself, and there impregnated the ovum on the surface of the Ovary. Some excellent authorities, in fact, insist that all normal impregnation occurs at the end of the Fallopian Tube--the point of its entrance into the upper part of the womb, rather than in the body of the womb, or at its mouth, as the older authorities taught. But wherever the actual contact of spermatozoon and ovum occurs, the blending of the elements is performed and fertilization, impregnation, or fecundation is accomplished.

As a result of copulation, then, the spermatozoon (or a number of spermatozoa) comes in contact with the female ovum or egg. Then one or more of them, by means of a furious lashing of the tiny tail, manages to penetrate the outer covering of the ovum, and enters the space between the outer covering and the real body of the egg. Several spermatozoa may effect an entrance into this outer space, BUT ONLY ONE IS PERMITTED TO ENTER THE REAL BODY OF THE EGG. [Twins are produced by the impregnation of two ova by two spermatozoa, at the same time. The presence of the two ova at the same time is unusual]. The moment that the real body of the ovum is penetrated by the successful spermatozoon, a tough covering or thick membrane forms around the ovum and thus prevents the entrance of other spermatozoa. The successful spermatozoon then loses its tail, and the remaining head and body become what is known as "the male pronucleus."

The authorities are uncertain as to the exact nature of the change which occurs when the ovum is penetrated by the spermatozoon. The outward manifestations of the change and transformation arising from the blending of the male and female elements are of course well known, but the "life process" eludes the power of the microscope. When Nature forms the thick membranous coating over the impregnated ovum, she draws the veil over one of her most important secrets. The first segmentation-nucleus having been formed by the blending and forging together of the male and female pronuclei, the process of segmentation begins.

Segmentation proceeds as follows: the impregnated egg splits into halves, forming two joined cells; then into quarters, forming four joined cells; then into sixteenths, then into thirty-seconds, sixty-fourths, and so on, until the ovum consists of a combined mass of very minute granular-like cells, the whole resembling a mulberry. The segmentation of the nucleus precedes and then continues with the segmentation of the yolk. After the egg has been divided into a great number of these cells, the latter begin a centrifugal action resulting in the formation of a complete inner lining of closely packed cells, with a central cavity filled with the yolk liquid.

In the meantime, the Uterus has been prepared for the reception of the impregnated and transformed ovum. A thick, spongy, juicy, mucus membrane forms, into which the changing ovum passes and attaches itself; the mucus membrane soon enveloping it and shutting it off from the rest of the Uterus. There now appears at one point on the ovum an opaque streak, which is called "the primitive trace" of the embryo--the first beginning of the young living creature. The "primitive trace" then grows in length and breadth. At this point we must leave the history of the ovum, or human egg, for the present; its further development will be related in the succeeding lesson, the subject of which is "Gestation."

LESSON IV

GESTATION OR PREGNANCY

Gestation is "the act of carrying young in the Uterus, from the time of conception to that of parturition." Conception occurs at the moment of the impregnation of the ovum; parturition is the act of delivery, or childbirth. Pregnancy is "the state of being with child." The terms "period of gestation," and "period of pregnancy," respectively, are employed by medical authorities to designate the time during which the mother carries the young within her own body--from the moment of the impregnation of the ovum until the moment of the final delivery of the child into the outer world.

The term of pregnancy in woman continues for over nine calendar months (or ten lunar months)--from about 275 to 280 days, though in exceptional cases it may be terminated in seven calendar months, or on the other hand may continue for ten calendar months. The usual method is to figure 280 days from the FIRST DAY of the LAST MENSTRUATION. A simple method of calculating the probable date of delivery is as follows: COUNT BACK THREE MONTHS, AND THEN ADD SEVEN DAYS, AND YOU WILL HAVE THE DATE OF PROBABLE DELIVERY. Example: A woman's FIRST DAY OF LAST MENSTRUATION is March 28. Counting back three months gives us December 28; and adding seven days to this gives us January 4, as the date of probable delivery. There will always be a possible margin of a few days before or after the ascertained probable date--but the delivery will very closely approximate said date. Ignore the shortage of days of February in this calculation, the same being covered by the general margin allowed.

DEVELOPMENT OF THE IMPREGNATED OVUM. In the preceding lesson we terminated our consideration of the impregnated ovum at the point at which, after the process of segmentation, the "primitive trace" had appeared. This primitive trace appears as an opaque streak, or straight line, formed of an aggregation of cells of a distinctive quality. This delicate "trace" or "streak" is the first indication of the form of the coming child. It is the basis, pattern, or mould, in or around which the spinal column is to be formed, and around which the entire young body is to be developed by the wonderful and intricate processes of dividing and reduplication, and the folding and combination of cells. From one end of this "trace" develops the head; from the other end develops the lower end of the spine. At a later stage there appear tiny "buds" in the positions at which the arms and legs should be; these gradually develop, and their ends split into tiny fingers and toes, and finally are transformed into perfect little arms and legs, miniatures of those of the adult human being.

The term "the embryo" is employed to designate the developing young creature in the earlier stages of its development, particularly before the end of the third month of its existence. After the end of the third month the embryo is called "the fetus." In the short space of 280 days the young creature evolves and develops from a single simple cell into a complex organism--a perfect miniature human being. Nature works a wonderful miracle here, and yet so common is it that we take it all as a matter of course, and lose sight of the miracle. From the most simple forms are formed in the developing creature the most complex organs and parts. The heart is formed from a tiny straight line of cells, by enlargement and partition. The stomach and intestines, likewise, develop from a tiny straight line of cells arranged as a tiny tube--the stomach is formed by dilation of one part of the tube, while the large intestine experiences a similar though lesser distention and a greater growth in length; the smaller intestines being formed by growth in length and circumference. The other organs evolve from similar simple beginnings.

The embryo is nourished during its earlier stages by means of the "yolk sack," or "umbilical vesicle," which is outside the body of the embryo, being joined to it by means of the umbilical duct. This yolk sack (originally formed by a "drawing together" in the ovum, which thus separates itself into two portions or areas) is an important feature of the life of the embryo, as it nourishes and sustains it in its earlier stages. Blood vessels form in this yolk sack, and after a time its fluid is absorbed, and after the third month the sack gradually disappears.

After the passing away of the yolk sack, the embryo is nourished and sustained by the "allantois," another peculiar sack which is formed. This sack readily becomes filled with blood-vessels, and serves to nourish the embryo by sustenance obtained from the body of the mother through the walls of the Uterus, a direct communication with the blood-vessels of the mother thus being secured. The blood in the embryo, and that in the mother, come into close contact, thus allowing the embryo to be nourished by the blood of the mother. After a time, in turn, the allantois diminishes and dwindles away, its offices being taken up and performed by the "placenta" or "afterbirth."

THE PLACENTA OR AFTERBIRTH. The Placenta, or afterbirth, is a round, flat substance or organ, contained within the Uterus, by which communication and connection is established and maintained between the fetus and the mother, by means of the umbillical cord. It is a flat, circular mass, about seven inches in diameter, and weighing about sixteen ounces. It is attached to the sides of the Uterus of the mother during the period of gestation, and is expelled from the body of the mother, as "the afterbirth," after the birth of the child.

Let us pause a moment, and reconsider the several steps in Nature's plan for nourishing the embryo and fetus. In the first place, as we have seen, there is the yolk sack or umbillical vesicle, filled with a fluid which nourishes the embryo. This gradually disappears in time, and is replaced by the "allantois" which by connection with the walls of the Uterus is enabled to nourish the fetus from and by the blood of the mother. For a short time, however, the embryo is nourished by both the yolk sack and the allantois. Then the allantois assumes the entire task, and the yolk sack passes away. Then, later, the placenta replaces the allantois, and the latter passes away as did its predecessor. The placenta works along the same general lines as the allantois, but is a far more complex way and with a much higher degree of efficiency, as we shall see presently.

The placenta is connected with the body of the fetus by what is known as "the umbillical cord." The "umbillicus" or "navel" in the human being marks the place at which the umbillical cord entered the body of the fetus, from which it was severed after the birth of the child. The purpose of the umbillical cord is to contain and support the umbillical arteries and veins through which the fetus obtains nourishment from the placental substance, and through which the return blood flows. The rich red arterial blood is carried from the placenta to the fetus, and is then distributed over the body of the fetus, nourishing and building it up; the dark venous blood, laden with the waste products of the body of the fetus, is carried back to the placenta, there to be repurified and rendered again rich and nourishing.

The story of the circulation of the blood of the fetus is most interesting. Although the fetal blood is derived from that of the mother, as we have said, yet the maternal blood does not pass directly from the circulatory system of the mother into that of the fetus; nor does the blood of the fetus return directly into the circulatory system of the mother. In fact, the fetal blood never comes in direct contact with that of the mother, or vice versa. The fetus has an independent circulatory system of its own, and yet, at the same time, from the moment of the placental connection until the moment of childbirth, all its nourishment is derived from its mother.

The secret of the above paradoxical statement is made apparent when we understand the meaning of the scientific term "osmosis." Osmosis is "the passage of a fluid through a membrane"; it is a chemical process, caused by the chemical affinity between two liquids or gases separated one from the other by a porous diaphragm or substance. In the process of osmosis in the case before us, the fetal blood takes up nourishing substances and oxygen from the blood of the mother, and passes on to the latter the waste products of the fetal system, by means of passing these substances through the thin porous membranes which separate the two independent systems of blood vessels, i. e., the system of the fetus, and that of the mother. Before birth, in fact, the fetus has its blood nourished and oxygenated by means of the food partaken of by its mother, and the oxygen taken in by the mother in her breathing. After its birth, the infant eats and breathes for itself, and thus nourishes its blood supply directly, instead of receiving it indirectly from the mother.

The Placenta begins to be formed about the third month of gestation, and continues to develop steadily from that time. At the time of the delivery of the child the Placenta covers nearly or quite one-third of the inner space of the distended Uterus of the mother. The total "afterbirth" consists of the Placenta, the umbillical cord, and the remaining membranes of the ovum, all of which are expelled after the birth of the child.

THE AMNION. An important appendage contained in the Uterus in connection with the developing fetus is that known as "The Amnion." This is an inner sack which forms within the womb, and which serves to enclose the fetus, and also to sheath the umbillical cord. The Amnion encloses the embryo very snugly during the early stages of its development, but it gradually becomes distended with a pale watery fluid, known as "the amniotic fluid," the purpose of which is to "float" the fetus and to give it mechanical support on all sides. This fluid is composed of water carrying in solution small quantities of albumin, urea, and salt.

SEX IN THE EMBRYO AND FETUS. It is impossible to determine the sex of the embryo during its early stages. During the fourth week the first traces of the sexual glands appear, but not until the fifth week can the sex be determined even by the microscope. If the embryo is to become a male, certain ducts are transformed into convoluted tubules, and each is attached to the testes which have been formed from the genital nucleus. If the embryo is to become a female, the ducts join to form the uterus and vagina, other portions being transformed into the fallopian tubes and connecting with the ovaries which have been formed otherwise. The outer genitals appear in the early stages of the embryo, but there is no apparent distinction between the sexes, the external organs being the same in all cases, and consisting of a small tubular organ with a small lateral fold of skin on either side. Later, in the male, a groove appears on the under side of this primitive organ, thus forming the urethra, the scrotum being formed from the folded skin at the side. In the female, the primitive organ ceases to develop as in the male, and thus becomes proportionately smaller, and evolves into the clitoris of the female; the two lateral folds, on each side, being transformed into the labia majora, or "outer lips" of the female external genitals.

POSITION OF THE FETUS. During the period of gestation the fetus lies "curled up" in the bag of the amnion. The head is usually relaxed and inclined forward, the chin resting on the breast; the feet are bent up in front of the legs, the legs bent up on the thighs, the knees separated from each other, but the heels almost touching on the back of the thighs; the arms bent forward and the hands placed between them as though to receive the chin between them. The folded-up fetus forms an oval, the longest diameter of which is about eleven inches at its greatest stage of growth. Nature here shows a wonderful ability to pack the fetus into as little space as possible, and in such a position as to protect it from injury, and to discommode the mother as little as possible.

The following interesting statement made by Helen Idleson, M. D., in a European medical journal several years ago, gives a very clear idea, expressed in popular terms, of the appearance and characteristics of the embryo or fetus in the various stages of its development: