grouped as pathological occur in girls. Thus, we meet with cases in
which menstruation becomes established at the age of eight, five, two,
or even earlier.[53] Carus reports the case of a woman whose medical
history showed that she had begun to menstruate at the age of two years,
and that she became pregnant for the first time when eight years old. In
girls from ten to twelve years of age, pregnancy has many times been
observed. A French physician had under observation a girl who when only
three mouths old had well-developed breasts, and in whom only a little
later the pubic and axillary hair grew and menstruation began. When
twenty-seven months old, the child was again seen by the same physician,
and at this time menstruation was proceeding regularly; the features had
now lost the infantile type, and the body as a whole exhibited all the
signs of premature development. A collection of cases made by
Gebhard[54] contains one case in which menstruation was established at
birth; in quite a number of the cases menstruation began during the
first year of life.

A case was reported from New Orleans in which menstruation began at the
age of three months and continued regularly thereafter. This was a case
of premature general growth; at the age of four years the girl was over
4 feet high, and her breasts were the size of a large orange. As a
general rule, in these cases of premature development of the
reproductive organs in girls, the great size of the breasts attracts
especial attention. According to Kisch (_op. cit._, p. 78), these girls
with precocious menstruation and premature sexual development very
commonly exhibit also a comparatively high body-weight, great
development of fat, and early dentition; they look older than their
years, and their genital organs also develop very early, with hair on
the pubes and in the axillae; the labia majora and the breasts resemble
those of full-grown women, and the pelvis also has the adult form.
Commonly also the sexual impulse develops early, whilst in other
respects the mental development lags behind the physical.

In the post-mortem room, corresponding conditions are occasionally found
in the ovaries; and some writers express the opinion that such premature
sexual development is commoner than would appear from the comparative
rarity of reports on the subject. Unquestionably, examination of the
ovaries of young girls not infrequently leads to the discovery of ripe
ovarian follicle