question of sex-predetermination, that it would be well to survey the
multiple causes of the scepticism hitherto expressed by some biologists
at the mere mention of the “Side-Theory,” since this theory forms an
integral part of my principle.
The root of my argument lies in the statement that the right side
contains male ova only, and the left side female. I have examined the
“Side-Theory” from all points of view and studied the history of its
origin from every source at my command. To satisfy the judicial and
unbiassed mind, one must hear each argument and then methodically
endeavour to answer one by one with irrefutable proof and evidence;
only so can the truth of the theory be established, and the weakness or
irrelevance of the criticisms advanced against it demonstrated. It is not
an uncommon thing for a woman, for one cause or another, to have one or
both of her ovaries removed.
I have gathered many instances of this, and it may be said definitely
that no woman who has ever had her right ovary and tube completely
removed, has ever given birth to a boy subsequently; and similarly after
removal of the left ovary and tube the birth of a girl is not possible.
A few critics have written to me from various parts of the world
intimating a knowledge of cases where the right ovary had been removed,
and yet a boy had been born, and vice versa, drawing the conclusion that
such evidence entirely disposes of my theory.
My reply to them is that I can go further, as I know not only of
instances such as they draw my attention to, but others in which both
ovaries have been removed, and yet children of _both_ sexes have since
been born. The explanation is perfectly simple. It sometimes happens that
if the operation is not absolutely complete, a vestige of pedicle stump
remains sufficient to harbour one mature vesicle, and that being so,
pregnancy undoubtedly becomes possible.
Some time ago a rising young surgeon expressed the wish that he might
come across one single case of a woman bearing a child, after both
ovaries had been removed. Then only, he said, would he be prepared to
“accept the theory of sides in its entirety.” Shortly afterwards he was
able to realise his ambition. A medical friend of his delivered of twins
of differing sex a woman who had actually been operated upon by that same
surgeon a year or two previously, when both ovaries had been removed.
From medical authorities I have been able to gather a few more such
cases, to add to my own list. And it is only recently that a lady wrote
to me: “I had both ovaries removed and tubes, but since then have given
birth to a boy and a girl.”
Experiments on animals, after the removal of both ovaries, go to prove
that they may still produce young, just as cases are recorded of certain
male animals being able to fertilise a single time after being castrated,
and the explanation is simple. In ovariotomy it is sometimes difficult to
ascertain that all ovarian tissue has been completely removed. Some of
the tissue may yet remain in the pedicle stump, and if this pedicle stump
be long, one cannot say how far up the ovarian tissue may extend.
Montgomery gives a case of boy and girl twins born in such circumstances.
In the postmortem on the mother only one corpus luteum was discovered,
the left ovary having been removed. The pedicle stump, had, however,
harboured the female Graafian follicle; hence the girl. On the right
ovary, the single corpus luteum could not possibly have contained the
_two_ Graafian follicles necessary for the embryo of each sex. A lady
I knew of, who had her right ovary removed, became pregnant two years
later; about the third or fourth month she was taken very ill with pains
in her right side and intense hemorrhage. The doctor advised an immediate
operation for tubal pregnancy; this, however, was not eventually found
necessary, as the trouble subsided, with the discharge of a blighted
fœtus. Later, the patient was assured that this side would be of no
further use to her, as the tube “had evidently burst”; thus precluding
any hope of future offspring; this diagnosis proved wrong, because she
has since then given birth to two sons.
Twins may arise from the same follicle, but they will be of the same sex.
Menstruation may continue after both ovaries have been removed, and
invariably does so where only one has been removed. But the fact of so
many women being able to conceive after bi-lateral ovariotomy, and to
conceive twins of either sex, when only one corpus luteum has been
found in either pedicle stump, proves to the hilt the truth of the
“side-theory.”
Another striking testimony to the law of sides is afforded by tubal or
uterine pregnancy. This unfortunate condition is caused by the ovum being
arrested in its passage from the ovary into the uterus, and so being
fertilised while yet in the tube. A morbid state of the tube, which has
possibly formed adhesion with the ovary or other parts, may be due to
congestion or contraction of its natural diameter. This practically never
occurs except where previous children have been born and is most common
where there has been abnormal distension, such as an unusually big child
or twins might cause. Death may ensue from the bursting of the tube, and
the results of many post-mortems on such cases have added their testimony
to the correctness of my theory.
Male tubal-pregnancies are the most usual, since the right tube is the
largest. Dr. Seligsen of Moscow collected fourteen cases of males in
the right tube; of females developing in the left I have collected five.
In one case, where a female fœtus was found in the left tube, which
was removed, the mother recovered and had a boy four years later. Of
the right tube I have collected six cases. In two the mother recovered
without the tube having to be removed, the fœtus coming away at four
months after acute pain in the right side. If, however, the pregnancy
lasts for over sixteen weeks the tube invariably bursts, unless otherwise
relieved.
In another case the right tube, without bursting, ejected the
cigar-shaped male fœtus at four months, after severe hemorrhage. The
patient recovered, but two months later a second male fœtus was ejected
from the uterus, and severe ovaritis ensued. This was cured and the
woman became pregnant again of another male fœtus which aborted at two
and a half months. The ovaritis reappeared, whereupon an operation was
performed, and the appendix was found to be adhering to and pressing
against the ovary. After the removal of the appendix, the ovary promptly
recovered its normal health. The original cause of this trouble had been
the abnormal size of twin-boys, born some two years previously.
A girl under my observation had to have her left ovary removed, before
she grew up, as the result of a severe accident; later on she married,
and gave birth to six boys in succession. Another girl who also had lost
a left ovary married and gave birth to a boy and then to twin-boys; since
then, she has had two male miscarriages at four months; neither of these
women ever had female issue.
A girl who strained herself at thirteen playing tennis, complained ever
after of pains in the left groin; she married and has given birth to
seven boys in fifteen years; evidently her left ovary had been rendered
inoperative. Numerous instances of this kind could be given, and every
case I have come across has emphatically endorsed the side-theory.
No doubt there are occurrences which seem to tell in the opposite
direction. For example a male fœtus may be found growing in and
distending the tube leading to the womb from the left ovary. But this
can be explained quite naturally by the fact that the male ovum had
journeyed from the right ovary, down the right tube into the womb, and
then, instead of remaining there, had passed right across the cavity into
the left tube; here it had become lodged, and so developed into a male
fœtus; this is called “internal migration.” Or again it may by “external
migration” have passed across the pelvis cavity, along the peritoneal
surface of the intestines, to the external opening of the opposite
tube—the left.
This, however, savours of an accident, and in no way disproves my theory
that the right ovary produces male offspring, and the left female _only_.
Experts have mentioned both these anomalies, but have so far offered no
explanation, though Pouchet advanced the doctrine that there might be, in
these cases, “aberration in the dispersion of the semen which does not
follow its natural course,” of which no proof is even suggested.
Professor Scanzoni cites the case of a woman who after a quarrel with
her husband, complained of severe pains in her _left side_ and died that
night. On examination a laceration was found on the left side of the
uterus, in which were the membranes and placenta of a fœtus, but there
was every evidence that the ovum had originated from the right ovary.[26]
A Mrs. C., after the birth of two girls, employed my formula and became
pregnant of a boy; at the third month the pregnancy, which proved to be
tubal, was terminated by the bursting of the tube which had subsequently
to be removed. The mother was saved, and it was found that, though the
child was a boy, the offending tube was the left one; and apparently
since the birth of the last girl this tube had remained abnormally
enlarged, and in an unhealthy condition, thus causing this anomaly.
Eighteen months later the lady conceived again; she miscarried of another
boy, and the right ovary was left in a state of acute irritation and
bound down with adhesions. It is some years since this happened, and she
has now succeeded in regaining her normal health and has at last produced
a much-needed son and heir.
“Placenta prævia” proves the complete vertical journey of the ovum;
in such cases, the ovum, having arrived in the womb, drops vertically
downwards to the lower part of that organ, instead of becoming embedded
in the upper part. Fertilisation ensues and the fœtus becomes attached to
the mouth of the womb, and if the child goes full time it is usually born
dead. Ovarian pregnancies are equally dangerous though fortunately rare.
Such abnormalities in no way reflect on the truth of the side theory;
on the contrary the abundant evidence I have collected corroborates in
every particular that the right side is proper to male issue, the left to
female.
XVI
TWINS OF MIXED SEXES
“All nature is but art unknown to thee,
All chance, direction which thou canst not see.”—POPE.
Hitherto no theory has been advanced which explained, in any satisfactory
or credible manner, the conception of twins of opposite sex. I maintain,
however, that, in the light of my investigations, it becomes a simple
and natural occurrence, and in this chapter I will briefly outline the
circumstances from which it may arise.
Twins may be conceived in two or three different ways:
1. A boy may have started at the beginning of the month, or toward the
middle, and a girl may be conceived seven days later or more, just
before the next period is due; the fact that the uterus does not always
close up entirely, and may even slightly re-open after conception, has
been sufficiently proved to make such an event entirely probable. To give
an instance, an American biologist mentions the case of a white woman who
gave birth to twins on two successive days, of which one was white and
the other black. She subsequently admitted intercourse with a coloured
man a few days after her husband had left her for a long period. Quite
clearly this woman conceived each twin on a different day, by a different
father.
The fact that so often, where the twins are of opposite sexes, one seems
to be less developed than the other, points to the probability of one
of them having been conceived one, two or three weeks later than the
other. When the girl is the smaller, which is often the case, we may
conclude she was the last conceived. If the boy be the smaller he was
conceived perhaps at a later date, and after the attempt at menstruation
which often occurs during the first or second month of girl-pregnancy. I
believe this manner of twin-conception to be rare, however. Out of twelve
cases of mixed twins collected recently, I have found only one where the
boy was smaller.
2. A boy may be conceived simultaneously with a girl if the ova from both
ovaries happen to be present in the tubes or uterus at the same time.
This would occur in the “blank week,” which, as we explained previously,
does not exist for certain women, if their period arrives every three
weeks. So, at the end of fifteen days, from the first day of period, the
left ovary, already active, his discharged an ovum before the male ovum
discharged by the right ovary has fully lost its vitality. Where this is
the case, both of these ova are equally ready for fertilisation. This
manner of conception is probably much rarer than that first considered.
It is very unlikely that a woman of irregular habits could produce two
ova each capable of forming a healthy embryo.
3. The conception of mixed twins has been explained in the following
way:—It is known that healthy spermatozoa may live for weeks in a
woman’s Fallopian tube. Thus, the male ovum having been fertilised on
the twelfth day or so after the first day of period, the female ovum
may be fertilised by the same issue of spermatozoa some ten days later.
This would also account for the smaller weight at birth of the girl. Any
exception, where the girl was the finer specimen of the two, might be
explained either by the arrested development of the male infant, owing
to a less healthy male ovary, or by the cornu of the uterus on that side
being less elastic and so preventing as full a development as that on the
left side.
This last theory of conception, which has the support of many biologists,
does not appear to me to be satisfactory. How can the fertilisation of
the left ovum by the belated spermatozoa be really effective? And, if
it is so, would not the lack of spontaneous vitality account for those
arrested pregnancies one so often comes across, and for which, up to
now, no cogent reason has been advanced? Faulty fertilisation might as
well be the cause of an abortion at any early state of one embryo whilst
the other continues its normal course.
I knew of one woman who, having had a mishap at thirteen weeks of a male
fœtus, was surprised on getting up again to find that she was still
pregnant. Five months later she gave birth to a healthy girl. Dr. Jameson
cites the following case. A lady he attended was delivered on February
13 of a healthy male child, whom she nursed. On April 3, however she was
taken ill, and shortly after was confined of a blighted fœtus, between
eight and nine inches long. This fœtus was attached to a placenta, which
appeared to be quite healthy, as large as that belonging to a full-grown
one.[27] Great numbers of such cases may be quoted, but till recently the
causes have been obscure.
It is commonly believed that when twins are of mixed sex one or the
other proves sterile when adult and there seems some ground for this
assumption, but it is not of universal application.
Difficult as it was, I have made every effort to get at the facts,
with the result that in scores of cases one or other of the twins has
been found to have remained celibate, or, after marriage, to have had
no children. I know of three sets only of mixed twins where both have
married and had families.
The bearing of twins apparently tends to be hereditary in the female
line, often recurring from mother to daughter, and this is more
frequently the case where the twins are of the same sex. These are the
result of a special development of one ovary or the other, accompanied by
a propensity to discharge two ripe ova simultaneously.
Triplets, quadruplets, and quintuplets are likewise produced for similar
reasons, as above described. In May, 1915, a Mrs. Howarth of Sheffield
gave birth to three boys and one girl. They have all survived and done
well. “An Italian woman at Palermo has given birth to five children, all
of whom are in perfect health,” was an announcement which appeared in the
papers not many months ago.
Such occurrences are quite tame compared to the account given by Ploss
of an Italian woman, named Dorothea, who in two births produced twenty
sons.[28] First, a bevy of nine arrived, and two years later eleven more
boys were born at one birth, these happenings being substantiated and
vouched for by the doctors Francesco Pico della Mirandola and Ambrose
Paré. The engraving, made from an authentic picture of this woman before
the birth of her many sons, is most extraordinary to behold: the curious
thing is that all were male children, so evidently the woman had a right
ovary abnormally developed to the complete extinction of the left.
Statistics go to prove, however, that the birth of female twins is more
common than that of male.[29] No doubt this is, in a measure, due to the
greater difficulty of carrying male twins.
I knew of a woman who, within two years, gave birth to two sets of male
twins; she subsequently bore first a single boy, and then a triplet of
boys. Her left ovary had previously been removed, as the result of an
unfortunate confinement when a girl-child was still-born; but she did not
carry the first male twins longer than a bare thirty-three weeks. Had she
carried them to their full term, it is doubtful whether she would have
made a normal recovery and been able to produce the other six boys.
Those women always recover most easily from boy twins who do not carry
them full time, and whose babies, when born, weigh barely from four to
five pounds each. Twins weighing together twelve pounds or more at birth
tend to overstrain the genital organs of the mother, with bad results.
The tube is frequently left in a disastrously distended condition, which
may lead to tubal pregnancies and appendix trouble.
Girl twins are seldom carried over eight months and are usually small,
entailing infinitely less strain on the mother. They are not only more
frequent, but easier to rear than boy twins. Mixed twins are the most
usual of any, and they are rarely like each other, whether in looks
or character. If they are very large, the result to the mother may
subsequently be sterility, but this is not by any means to be taken as a
general rule. I have known a woman start a fine family of six sons and
six daughters with a good-sized set of mixed twins.
Mr. Rumley Dawson divides twins into four varieties:
_Variety A._ One Boy: One Girl: One from each ovary—a different
Graafian follicle: a different ovum: generally one placenta to
each.
_Variety B._ Two of the same sex: One ovary: two Graafian
follicles: two ova: either two girls or two boys. In this
variety there may or may not be a placenta to each, but
generally there is only one.
_Variety C._ One Sex: one ovary: two ova contained in the same
Graafian follicle. One corpus luteum only will ensue from the
bursting of this Graafian follicle which contains two ovuli.
In this case the children will resemble each other—far more
closely than those coming under the first two categories. One
placenta only will be found.
_Variety D._ One Sex: one ovary: one Graafian follicle and
one ovum in which are contained two nuclei. These twins are
rare, once in seven only. Extremely similar they are often
joined together like the “Siamese Twins.” In triplets the same
conditions obtain, and one ovum may produce three nuclei, all
of the same sex.
As I have shown, twins are conceived according to all the rules laid
down by the much-discussed, but hitherto imperfectly, understood,
side-theory, and, where it was well-nigh impossible to explain clearly
the conception of twins of mixed sex, complete understanding is now
afforded by our newly acquired knowledge of the functioning of the left
ovary.
That twins are the result of a peculiar condition of the ovary, usually
hereditary, I have already indicated; it clearly follows therefore that
multiple pregnancy cannot be initiated at the parental wish. But, where
there is a marked family inclination to twins, _it is certainly possible
to ensure their being male or female_, according to desire, provided they
be both of the same sex.
XVII
“BEFORE OR AFTER”
“Count it crime to let a truth slip.”—BROWNING.
Hippocrates maintained that the male fœtus became animated thirty days
after conception, while the female required forty-two days to become
animate. This exactly bears out, and is explained by, the theory set out
in my formula that a male conception occurs during certain days after the
period, and a female somewhere between the twenty-first and twenty-eighth
day: that is, eight to twelve days later.
Montgomery, in the year 1850, was of the opinion that conception could
occur apart from the previous influence of menstruation. For, as he said,
if they are necessarily dependent the one on the other, “no woman could
conceive at any time, except at, or just after, the menstrual period.”
And in support of this he refers to instances of women who, having
never menstruated, yet became pregnant, and also of girls who had borne
children before they menstruated.[30]
In such an event the left ovary would always be the first to operate.
Nysten records the case of a girl of thirteen, who, having not yet
menstruated, died at the Hotel Dieu, Paris; after death a tumour was
found in the situation of her _left_ ovary, having every appearance of a
blighted fœtus.[31] In my investigations I observed the case of a village
girl of nineteen who became pregnant, and at seven months was taken
seriously ill. Up to the actual moment of parturition, both the midwife
and the girl’s mother refused to believe that the labour pains could
betoken a possible pregnancy, as the patient had never menstruated; she
gave birth to a premature female infant.
A young married woman, whom I met recently, gave birth to a baby girl,
although she had not menstruated for two years before becoming pregnant,
and could give no dates to her doctor for calculating the date of the
babe’s arrival.
Mr. Whitehead, of Manchester, has given particulars of nine cases in
which pregnancy occurred previous to menstruation. He did not give the
sex of the offspring, but, according to all the evidence I have been able
to collect, such pregnancies almost invariably result in female issue.
My explanation is that menstruation was either temporarily suppressed,
or that it did occur, but was so scanty as hardly to be recognised for a
normal period. We must, therefore, accept it as extremely unlikely that
ovulation which, as before explained, is the discharge of a ripe ovum,
can occur apart from the influence of menstruation.
Biologists, who at one time believed that ovulation must happen
simultaneously with menstruation, found it difficult to account for
the large numbers of conceptions occurring before the beginning of the
catamenial flow, or after its complete cessation. The suggestion that
the spermatozoa might lie in wait for the ovum is not reasonable, taking
into consideration that the actual monthly discharge, when at its height,
would almost certainly carry off the spermatozoon, which is still in the
nature of a foreign body until it has fertilised the ovum.
Another popular idea is that _ovulation and fertilisation_ are
spontaneous. This implies a _necessary_ state of consciousness and active
responsiveness on the part of the female, which cannot be backed by any
kind of circumstantial evidence. Too many examples exist of women who not
only had no sensation during conception, but became pregnant under the
influence of drugs, asphyxia, drunkenness or even deep sleep. Also the
fact of rape, which has so often resulted in offspring, again disposes of
the natural and perhaps more pleasant conclusion of mutual spontaneity
in impregnation. It must strike one that nature seems to have made a
slip in this respect, thereby involving in undue horrors and anxiety the
victim of criminal assault.