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288                                               MEDICAL JURISPRUDENCE

in her tastes, and the girl no longer looks like a child but is more bashful
and retiring. Luxurious living and early stimulation of the mental faculties
tend to bring on menstruation at an earlier age, jwhile-foeble health and
poor diet tend to retard it.

In exceptional cases menstruation may appear very early or late in life.
Arnold Gesell14 reports the case of a girLHho^began to menstruate at the
age ofjthree years and sev^eji^n^nj^^                                                01 a

cEH37 aged fou^j^ars-t^who Jigeoljto^have a discharge_of bloodfrom^ jthe
vagina eyerysix or eight weeks. The laHsTwereTiarge an^TTn^Breastsas
large as ^ ^e^alvesm^^ara'^^S^Site sizedorange. C. Worster-Drought 16
reports the case of a girl, aged 5 years7wKoT)egan to menstruate at the age
of jitjiears and continued to menstruate regularly for 12 months, the period
lasting each time for three days. Menstruation stopped for 18 months and
then reappeared. Since then it has been more or less regular. The breasts
were noticed to be prominent at birth, but there was a sudden increase in
size at the onset of menstruation. Pubic hair appeared at the age of 4 years
and six months. P. M. Sen Gupta17 also records the case of a girl who
began to menstruate at the age of 3i years. At first the flow came on every
month, then the intermenstrual periods lengthened to about two months and
the last interval was over six months. At the age of 5 years she was quite
intelligent, her breasts were considerably developed and there was slight
growth of pubic and axillary hair.

Cases of delayed menstruation have also occurred. I have known a
family where girls did not menstruate till they were

Powell ls has known women of twenty^yjsars who had not mengtruatgd.

It is generally assumed that the power of fecundity commences with the
first flow of menstruation, and lasts till the menopause, which occurs on an
average at the forty-fifth year of age, although it may occur in a few cases
at an earlier age or as late as the fiftieth year.19 For obvious reasons such
a view is not tenable in the case of babies and small girls who menstruate
prematurely. Cases have, however, occurred where girls became pregnant
at a very early age. A Mahomedan unmarried girl,20 6 years and 8 months
old, who had never menstruated, was delivered of a full-term female child
by Caesarian section in the Zenana Hospital at Delhi. She was able to nurse
her child. McCann21 quotes the case of a girl who gradually developed
secondary sex characters in the breasts and pubes, and began menstruating
at the end of the fourth year of her age. She became pregnant at the age
of 6i years. F. D. H.22 reports a case where the operation of Caesarian section
had to be performed on a little girl, both at the birth of her twin babies
when she was ten years old, and at the birth of her living child before she
was eleven years of age. On the contrary, ovulation may continue in rare
cases, even though irregularly for varying periods after menstruation has
stopped permanently. An ovum discharged at such type of irregular
ovulation can, if fertilized, lead to pregnancy just as in the sexual period of
life. K. P. Bhadury23 cites two cases of pregnancy after the menopause.

14   Jour. Amer. Med. Assoc., March 17, 1928, p. 840.

15.   Jnd. Med. Gaz., June 1902, p. 233.

16.   Proceedings of the Royal Soc. of Med., Aug. 1931, p. 1,338.

17.   IiwL Med. Gaz., June 1937, p. 368.

18.   IncL Med. Gaz., June 1902, p. 233.

19.   According to Miss Curjel the average duration of menstrual life   (reproductive)
among Indian women is 32.14 years, and this does not appear to differ materially from
European races™— Ivtd. Jour, of Med. Research* Oct. 1920, T>. 566.

20.   Jour. M, MecL Assoc^ Aug. 1932, p. 535 ; Keane, Brit. Med. Jour., Sep. 23, 1923,
p. 5$L

21.    Medico-Lefr and Crvminolog, Rev^ Vol. IV, Part I, Jan, 1936, p. 30.

22.    Times of India, Harcfe 15, 1926.

23.   Jour. Ind. Med. A&SQC^ Bee. 19^9,* p.. 105.