The Case of a Full Grown Woman in Whom the Ovaria Were Deficient

XIII. The Case of a full grown Woman in whom the Ovaria were deficient. By Mr. Charles Pears, F. L. S. Communicated by the Right Hon. Sir Joseph Banks, K. B. P. R. S. Read May 9, 1805. The following case is laid before this learned Society, as an addition to those already registered in the Philosophical Transactions, with the view of elucidating such physiological inquiries as are connected with the state of the organs of generation. Ann Joseph was born at Diserth, in Radnorshire, North Wales, August 4, 1770. She was of a fair florid complexion, and blue eyes, dark-brown hair, a flat nose, and thick lips. She was naturally mild, but when irritated, was sometimes malicious and revengeful. In her diet she was remarkably abstemious, eating little of animal food, no fresh vegetables, and so small a portion of bread, that she often did not consume a penny loaf in the course of a week. If at any time she was prevailed upon to take several kinds of food, her stomach was so much affected by it, that she fainted away; and if she had eaten a hearty meal, these faintings would be repeated. She was of a costive habit, seldom having a passage in her bowels oftener than once in nine days, and sometimes only once in fourteen. She slept well, and could endure hard work, but was slow in performing it. Having ceased to grow at ten years of age, she was in stature not more than 4 feet 6 inches MDCCCV. high. Her breadth across the shoulders was as much as 14 inches, but her pelvis, (contrary to what is usually observed in the proportions of the female skeleton,) measured only 9 inches, from the ossa ilia across the sacrum. Her breasts and nipples never enlarged more than in the male subject; she never menstruated: there was no appearance of hair on the pubes, nor were there any indications of puberty either in mind or body, even at twenty-nine years of age; on the contrary, she always expressed aversion to young men who were too familiar with her. At the age of twenty-one she expressed much uneasiness at finding herself different from other young women, which she attributed to not having menstruated; and was so desirous of relief that she frequently took medical advice for that purpose. From her infancy also she was liable to complaints in her chest, attended with cough, that came upon her at intervals in violent attacks, and increased in violence as she advanced in life. In her twenty-ninth year one of these attacks came on, attended with convulsions, of which she died after a few hours illness. After death, the female organs were taken out and preserved. In this state they were shown to Sir Joseph Banks, at whose request their internal structure was accurately examined, and the following appearances were observed, which are illustrated in the annexed drawing of them, made by Mr. Clift. The os tincæ and uterus had the usual form, but had never increased beyond their size in the infant state; the passage into the uterus through the cervix was oblique. The cavity of the uterus was of the common shape, and the Fallopian tubes were pervious to the fimbriæ; the coats of the uterus were membranous. The ovaria were so indistinct as rather to show the rudiments which ought to have formed them, than any part of their natural structure. All these appearances will be better understood by their representation in the annexed drawing (Plate V.) than from any description that can be given. The history of this case, with the account of the dissection, becomes valuable, as it shows that an imperfect state of the ovaria is not only attended with an absence of all the characters belonging to the female after puberty, but that the uterus itself, although perfectly formed, is checked in its growth for want of due structure of those parts. That there is an intimate connection between the ovaria and uterus has long been ascertained; but that the growth of the uterus should so entirely depend upon that of the ovaria, I believe to be a new fact; at least it has not been published in any work that has come under my observation.