Ernest Rumley Dawson.

The causation of sex in man; a new theory of sex based on clinical materials together with chapters on forecasting or predicting the sex of the unborn child and on the determination or production of either sex at will online

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preceding. I delivered her on March 15, 1912, of triplets
two girls and a boy; and eighteen months afterwards I
heard she had twin boys.

As in both these cases menstruation was absent many,
many months prior to conception, it looks as though the
contention that menstruation is a preparation for pregnancy
cannot be maintained for presumably the uterus must be
" prepared for pregnancy " or pregnancy could not take
place, and in both these cases no such preparation had taken
place, yet pregnancy occurred.

Unlike Marshall and Heape, Dr. T. G. Stevens^ says:

" Menstruation is much more likely to represent the failure of
the uterus to receive a fertilised ovum."

The actual cause of menstruation is unknown : it has been
ascribed to nerve influence, and is thought to be probably
controlled by an undiscovered nerve centre in the brain ; and
a sympathetic nerve ganglion in the ovary has even been
described. True menstruation occurs only in women and
a few (especially captive) monkeys; and has therefore been
attributed to their erect postures, in most mammals the
amount of blood not being sufficient to envermeil the

It may roughly be said that, normally, previous to the

1 Dr. T. G. Stevens, " Diseases of Women," p. 64, 1912.


onset of menstruation and after its cessation (the meno-
pause), women are incapable of bearing offspring or becoming
pregnant. This rule, however, like most others, meets with
a few unimportant exceptions. Thus Dr. Addinsell 1 relates
a case of pregnancy in a girl of 13 prior to any appearance
of menstruation; while of the rarer condition of pregnancy
after the menopause, the following is a case from my own
private practice: Early in March 1904 I attended Miss E. C.,
aged 50. She had passed " the change," and had seen
nothing for just two years. Meeting her former lover
once again after many years' absence, and, deeming herself
safe from the possibility of pregnancy, she ran the risk,
and was duly delivered by me of a living healthy male
illegitimate child, nearly three years after having ceased
to menstruate. Menstruation did not reappear.

A somewhat similar case is recorded by Dr. R. Hann 2
in a woman of 49 years, who gave birth to her thirteenth
child a boy three years after the menopause; but in this
case menstruation returned after weaning this child.

All authorities agree that, prior to puberty, the ovaries
of a girl present smooth surfaces; then, as Bland-SttUon 3
says, " from puberty to the menopause the smoothness of
the surface is marred by scars, caused by the rupture of
mature follicles " that is, by ovulation. So that prior to
puberty, " strikingly declared by the institution of menstrua-
tion " (Bland- Sutton), ovulation has not occurred to scar
the smooth surface of the ovaries.

The two processes, ovulation and menstruation, evidently
both depend upon a common cause, possibly a periodical
congestion induced and controlled by a nerve impulse;
having the same cause, they usually occur about the same
time i.e. they are nearly if not quite synchronous.

Heisler 4 says " the two processes (ovulation and menstrua-
tion) usually occur at the same time "; so that Temesvary 5

1 " Lancet," March 25, 1905, p. 791.

2 R. G. Hann, " Journal of Obstetrics and Gynaecology," September
1902, p. 290.

3 Bland-Sutton, " Diseases of Ovaries," 1896, p. 26.

4 Heisler, " Text-book of Embryology," 3rd ed. 1907, p. 38.

5 Temesvary, " Journal of Obstetrics and Gynaecology of the British
Empire," vol. iii. 1903, p. 512.


calls menstruation " the outer sign of ovulation." Heisler 1
also says " the ovum is usually discharged from the ovary
during the menstrual period."

That ovulation can occur without menstruation is evident
from those rare cases where young girls become pregnant
before menstruation has begun.

This is chiefly due to the fact that the ovaries and their
contained ova are fully developed earlier than the uterus
(see remarks of Spiegelberg, p. 20 ante), so that a mature
ovum may be formed some time before the uterus has
developed sufficiently to menstruate. The fertilisation of
the ovum and its consequent attachment to the wall of the
immature uterus cause the rapid and complete development
of the uterus, so that the pregnancy continues and the child
is born before its mother has even menstruated; but the
pregnancy will have caused the full development of that

Ovulation must occur without menstruation in those
cases where women get pregnant during lactation, when
menstruation is often absent.

There are many reasons for believing that usually ovula-
tion continues with its habitual regularity throughout the
lactation period, the process of lactation replacing that of
menstruation; but for pregnancy to occur before the re-
appearance of the menses is not usual, Remfry 2 giving only
6 per cent, as the number of non-menstruating women who
conceive during lactation, while 60 per cent, of women get
pregnant who menstruate during lactation.

The obvious criticism of both the above cases of ovulation
without menstruation is that, though both occasionally
occur, yet both are uncommon and more or less exceptional ;
in both cases fertilisation does not usually occur till after
the appearance or reappearance of menstruation.

That ovulation may occur and menstruation be absent
is most evident from cases where, though the ovaries are
present, the uterus is either entirely absent or so rudimentary
as to be functionless. Ovulation in this case cannot be
accompanied by its usual phenomenon of menstruation;
but we must not argue from congenital abnormalities.

1 Heisler, op. cit., p. 41. 2 Remfry, loc. cit.


That ovulation usually occurs only at or about the time
of a menstrual period, the previously mentioned exceptions
notwithstanding, is evident from the following facts.

After the discharge of an ovum a corpus luteum is formed ;
a corpus luteum, therefore, as we have already seen, signifies
a previous ovulation. The only ultimate trace of a corpus
luteum is a scar or cicatrix on the surface of the ovary.

If, therefore, ovulation occurred oftener than at or about
the time of a menstrual period, the signs of the previous
ovulations, viz. scars of corpora lutea, would be increased
in number, and would not correspond to the number of men-
strual periods experienced, as they practically invariably do.

If ova were habitually discharged independently of
menstruation say one or two ova every week, and by
each ovary then at the end of a lunar month of four weeks
we ought to find post-mortem from eight to sixteen corpora
lutea in the two ovaries for each month or menstrual period,
which is absurd. 1

W. Williams 2 says:

" We must conclude that ovulation and menstruation usually
occur about the same time, but that one not infrequently antedates
the other by a few days."

The fact should be pointed out that, if a girl have men-
struated only three times in her life, only .three ovulation scars

1 The statements made by some operators that during abdominal
operations Graafian follicles have been seen either " just ruptured, or
about to rupture, at all periods of time between two menstrual periods "
are fallacious if implying that this is a normal condition of things.

These cases are open to the criticism that operative cases are mani-
festly not normal ; then, too, the excitement incident to an approaching
abdominal operation, especially one on the sexual organs, is quite suffi-
cient to induce that extra activity, or undue congestion, which will cause
a ripening Graafian follicle to prematurely rupture.

It is notorious that the menstrual period is often thus expedited.

While as to those follicles thought, to be " about to rupture " we have
no evidence and no data on which to form an opinion of the imminence
of rupture of a follicle, so that the time of rupture of a follicle, deemed
" about to rupture," may well be a full week or more distant. It is an
assumption to allege that any follicle is " about to rupture " if its rupture
within a few hours is thereby meant.

Numerical agreement of the number of scars of corpora lutea seen
with the known number of menstrual periods experienced undoubtedly
show the normality of their synchrony.

2 Williams, op. cit., p. 77.


will be found in her two ovaries. If ovulation usually oc-
curred, say weekly, that girl, having seen three monthly or
menstrual periods, should have exhibited in her two ovaries
not three cicatrices only, but from twelve to twenty-four
at least, that is, one each week from each ovary; so that these
scars or signs of ovulation equal the number of menstrual
periods experienced.

Strassmann, quoted by Dr. Macnaughton- Jones, 1 says:

" Anatomical examinations on the number of corpora lutea,
contrasted with the number of known menstruations, establish the
connection between ovulation and menstruation"; and "Each
menstruation is the expression of an ovulation."

Whether the two processes strictly agree as to time is
immaterial; in fact, ovulation probably usually precedes
menstruation by a day or two. Ovulation is certainly
usually a painless and spontaneous process, which we are
quite unable to induce, though sexual excitement probably
helps to do so.

Ovulation is the function of the ovaries, the period of
functional activity of the ovaries is coincident with the
woman's menstrual life; so that both ovulation and men-
struation occur only during the period of a woman's potential

That menstruation and ovulation are dependent on a
common cause is evident from the facts that

What stops ovulation also stops menstruation: in the
complete congenital absence of the ovaries, though the
uterus be present, menstruation does not occur.

When the ovaries atrophy in old age, menstruation

When, as is normal prior to puberty, the ovaries are not
active and ovulating, menstruation does not occur, so that
when ovulation begins menstruation also usually begins.

Alban Dor an 2 has pointed out that among the Esquimaux,
during the Arctic winter, breeding is arrested, and is accom-
panied by cessation of menstruation during that time also;
so that the cold which stops ovulation also stops menstruation.

1 Macnaughton- Jones, " Diseases of Women," 8th ed. 1900, p. 34.

2 Alban Doran, " Trans. Obstet. Soc.," vol. xl. 1898, p. 166.


Dr. E. J. Tilt 1 mentions that the surgeon to Sir John
Ross' Arctic expedition reported that the Esquimaux women
only menstruate during the summer months.

Because instances have occurred where menstruation (?)
has recently happened, and no trace of the ripening of an
ovum has apparently been found, it has been alleged that
menstruation can occur without ovulation. This statement
must be accepted with great reserve. All haemorrhages in
women are not menstruation, and we require to exclude
several conditions and morbid growths as causes, before
deciding that the haemorrhage was a true menstrual period.
We should not forget that the haemorrhage from bleeding
piles has been taken for menstruation !

Then, too, failure to find what is deemed a recently
ruptured Graafian follicle is no proof that ovulation did not
occur, and it is probable that in young women a corpus
luteum of menstruation often disappears more rapidly than
we usually expect, and thus resembles a corpus luteum of
a former ovulation, and so is not ascribed to the recent

Confirmatory of this, W. Williams 2 says :

" In young women, in whom the circulation is active, the de-
generated lutein cells are rapidly absorbed, so that in a short time
the corpus luteum becomes replaced by newly formed connective
tissue which corresponds closely in appearance to the surrounding
ovarian stroma."

Some other cases may be explained thus; Leopold, 3 quoted
by Heisler, says:

" If rupture (of a Graafian follicle and extrusion of the ovum)
occurs during the intermenstrual period instead of at the time of
menstruation, haemorrhage will be small or entirely wanting, the
resulting corpus luteum being called then atypical, to distinguish it
from the typical body formed in the ordinary manner."

Again, haemorrhage, after the menopause or change of
life, often erroneously taken for menstruation, is necessarily
unaccompanied by the formation of a corpus luteum in
either ovary.

1 Dr. E. J. Tilt, " Diseases of Women," 1853, p. 112.

2 Williams, op. cit., p. 68.

3 Heisler, op. cit., p. 33.


We are forced, then, to agree with Horrocks 1 when .he

" There are no facts which proved that menstruation could take
place without ovulation."

As a matter of fact, menstruation cannot occur if all ovarian
tissue is absent; it is absolutely dependent on the presence
of some ovarian tissue.

1 Horrocks, " Trans. Obstet. Soc.," vol. xl. 1898, p. 173.


IN the human embryo the surface of each ovary is covered
by a thick layer of oblong or columnar cells the germinal
epithelium. From this germinal epithelium all the ova are
eventually developed.

Downgrowths of the covering cells or germinal epithelium
take place into the substance of the ovary, and from these
cells thus carried into the stroma of the gland the Graafian
follicles are formed, one or more cells being specially en-
larged to form the contained ovum or ova.

These ingrowths of the germinal epithelium take place
during intra-uterine life, so that at birth the child's ovaries
already contain, though in an immature form, the full
number of ova that the adult ovaries contain. The forma-
tion of new ova ceases with the birth of the child.

It will thus be seen that all the ova shed during a woman's
life are highly matured cells, whose development has been
slowly taking place prior even to the woman's own birth.

The ova are not the result of hurried growth, but of careful
and very deliberate preparation extending over many years.

No new Graafian follicles are formed after birth, but as the
two ovaries together are estimated at puberty to contain
some 70,000 Graafian follicles it is evident that only a very
few ever reach maturity. The majority of the follicles
never ripen, or, if they do, they do not burst they atrophy
and disappear.

Halliburton 1 says:

" Some of the Graafian follicles never burst ; they attain a certain
degree of maturity, then atrophy and disappear."

The human ovum, oocyte, or sexual cell is a spherical
particle of viscous protoplasm of a complicated chemical

1 Halliburton, " Handbook of Physiology," 5th ed. 1903, p. 801.



composition, varying from T |o to jiy in. in diameter; it is a
single living cell, capable of further growth and great develop-
ment if fertilised.

It soon dies after its discharge from the Graafian follicle
if not fertilised, its life being counted by days only thus
differing considerably from the male sexual cell, or sper-
matozoon, which can live for weeks even, in the Fallopian
tube of a woman.

Though our microscopes are not perfect enough to enable
us to detect any differences between them, each ovum has, I
maintain, its own definite and unalterable sex, being either
male or female, according to the ovary from which it is

And in the same way, the ovum of one woman is indistin-
guishable by microscope or any apparatus from the ovum of
another woman, yet we know there must be vast differences
between them; similarly the ovum of a negress is indistin-
guishable by our present appliances from the ovum of a
blonde, yet we know full well that if fertilised the one pro-
duces a dark child, while the other gives rise to a white one.

The difference must be there, but we cannot detect it; it
may be chemical and not discernible microscopically.

And in animals, just as surely as a cat's ovum, indistin-
guishable by microscope or other apparatus from that of a
bitch, will give rise to a cat and not a dog, so a male human
ovum, though we cannot yet by any of our present means
distinguish it from a female one, will as surely give rise to a
boy and not a girl, and vice versa the female ovum gives
rise to a girl and not a boy.

In structure an ovum is a typical cell, or circular mass of ^
protoplasm with a very fine and delicate cell wall or limiting
membrane, called the Vitelline membrane (see Fig. 10).
External to this, but separated from it by a little fluid
(the Perivitelline fluid), is a second protective cell wall, the
Zona pellucida or Zona striata.

The perivitelline fluid, therefore, occupies the perivitelline
space between the true and the secondary cell walls.

The zona pellucida (i, Fig. 10) exhibits hundreds of
fine lines or striae hence also zona striata radiating out-
wards; these fine hair-like lines are really pores or canals,



so that this cell wall is a porous one. Through these canals
the ovum is nourished, and through these " avenues of
entrance " the mov ng spermatozoa enter the ovum and so
reach the nucleus; they are really multiple "ways in"
for the spermatozoa.

In this respect the human ovum differs from those of the
invertebrata, which have only one such opening or " way
in " for the spermatozoa, called the micropyle; but, as we
shall presently see, only one spermatozoon is required to



FIG. 10. DIAGRAM OF A HUMAN OVUM. (Much magnified.)

Though this diagram represents the ovum as quite flat, it must be remembered it is a sphere,
and more nearly resembles a miniature orange than a vertical section of an orange as the figure
would appear to indicate. Compare Fig. 12.

i. Zona Pellucida, the thick cell wall, showing radiating lines, which are pores or entrances for
the spermatozoa. 2. Perivitelline space, containing the Perivitelline fluid. 3. The ovum
filled by the Yolk, or protoplasm loaded with food granules. 4. The nucleus or Germinal
vesicle. 5. The nucleolus or Germinal spot. 6. Vitelline membrane or delicate ovum wall.

enter the ovum of the invertebrata in order to fertilise it,
so that " the supply is equal to the demand."

The contents, yolk, or vitellus of the cell is protoplasm,
and situated eccentrically therein lies the spherical nucleus,
riff in. in diameter, called the germinal vesicle, and this
contains a nucleolus known as the germinal spot. The
nucleus or germinal vesicle is the most important part of the
whole ovum ; it is usually single, but there may be two
nuclei. It is junction with the nucleus of the ovum by the


head or nucleus of the spermatozoon that constitutes
fertilisation. We know nothing of the use or function of
the nucleolus.

To the protoplasmic vitellus or germ yolk of the ovum is
added material called deutoplasm or food yolk, designed for
the nutrition of the ovum during the first few days of its
development after fertilisation.

The germ yolk is always in great excess compared to the
food yolk in a human ovum.

All ova in which the protoplasm, or germ yolk, and the
deutoplasm, or food yolk, are uniformly distributed, as in
those of the mammalia, including man, are known as Aleci-
thal ova.

The eggs of birds, reptiles, and bony fishes arc known as
Telolecithal ova ; for the preponderating food yolk is accumu-
lated at one part of the ovum, and the protoplasmic germ
disk at, usually, the opposite pole.

NOTE. Some of the statements as to the very minute
structure of cells and their nuclei must be accepted with
some reserve, for in the staining and preparation of the cells
we cannot be quite sure that we have not ourselves caused
the appearances so described, so that the facts may be really
artificial ones, or artifacts, as they often are called. Hence
I shall not detail them, as they do not now concern us.


THE spermatozoa are the essential fertilising constituents
of the semen; they float in an albuminous fluid, the liquor

Each spermatozoon consists of a head eoVo in. long, and
a long slender tail from T Jo to - 5 Jo in. long; a middle portion
or body, thicker than the tail, is also described. They
therefore slightly resemble miniature tadpoles.

FIG. n. HUMAN SPERMATOZOA. (Highly magnified.)

H. The head, showing a nucleus. B. The body or middle piece. T. Long tail, the source
of the motility of the spermatozoon.

The spermatozoa are derived from the spermatoblasts or
cells, which form the most internal lining of the seminiferous
tubes or seminal canals of the testes. The nucleus of the
cell forms the head of the spermatozoon.

The long tail projects into the lumen of the seminal tube,
and when fully developed the spermatozoon is set free, and
is probably carried to the vesiculae seminales or receptacles
for the storage of the semen.

No spermatozoa are formed till after puberty, usually
about the fifteenth or sixteenth year; any seminal fluid in
younger boys usually containing no spermatozoa.

Under certain conditions in man the formation of sper-
matozoa is very rapid, but in no case is their preparation
such a long and careful process as is that of an ovum.

It has already been pointed out that the ova are all formed
before the child's birth even, the spermatozoa not till



puberty, hence the ovum is a far more slowly matured and
specialised cell than the spermatozoon. In size, too, the
ovum is much the larger and more important. The diameter
of the ovum is forty times greater than the length of the
spermatozoon's head, while the nucleus or essential portion of
the ovum is 7 <yo in. in diameter ; the head of the spermatozoon,
containing the nucleus or essential portion, is only eoVir in.
long; in fact, the spermatozoa are the smallest cells in the

The spermatozoon and ovum agree in that each is a small
mass of protoplasm containing a nucleus; the former repre-
sents a portion of the father's body, the latter a portion of
the mother's body.

The long tail of the spermatozoon is essential to its motility
or power of progression, and for the most part disappears
after the spermatozoon has entered the ovum that is,
when, having reached its goal, it is no longer required.


FERTILISATION is the incorporation of the essential portion
of the male fertilising fluid, or semen, with the ovum or egg
provided by the female.

The ovum before, and after, fertilisation are two vastly
different things: the unfertilised cell becomes an oosperm,
zygote, or fertilised cell, which differs from the original ovum
not only in its chemical composition, but also in its power of
life and growth. A portion of the male parent's body has
by means of the spermatozoon joined the ovum or part of
the mother's body, and the germ of a new being begins to

The youngest fertilised human ovum or oosperm ever
found and described was believed to be the one by Hubert
Peters, in 1897, in the uterus of a woman who committed
suicide three days after missing her menstrual period;
therefore it was at first claimed, on not very conclusive
grounds, to be of only three days' development: but we do
not know when the fruitful coitus took place it may have
been two or three days or even a week or more previous to
the day her period was expected to begin, hence five to
fifteen days would then represent its age. Though con-
sidered to be only three days old by Peters, the ovum,
W. Williams 1 says, " certainly presents a tolerably ad-
vanced stage of development."

A still younger oosperm has since been described by Drs.
Brycc and Teacher, who claim it to be about thirteen to
fourteen days old, while they judge Peter's fertilised ovum
to have been at least fourteen to fifteen days old.

Graf Spec has described two very early fertilised human
ova, but both were slightly older than that of Peters.

1 Whitridge Williams's " Obstetrics," p. 88.



The youngest I have personally met with was certainly
less than fourteen days old.

If, therefore, the youngest oosperm ever seen was at
least thirteen days old, it follows that the actual fertilisation
of the human ovum has never been observed, hence the minute
processes and early phenomena incidental to the fertilisation
of the human ovum are quite unknown, as Dr. J. W. Ballan-
tyne 1 says:

" No biologist and no embryologist has ever seen the human
ovum entered by the human spermatozoon."

Dr. Eden 2 rightly says: "The details of the process of
fertilisation naturally cannot be studied in the human
species"; so that the descriptions given in many books as

1 3 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Online LibraryErnest Rumley DawsonThe causation of sex in man; a new theory of sex based on clinical materials together with chapters on forecasting or predicting the sex of the unborn child and on the determination or production of either sex at will → online text (page 3 of 18)