When, years ago, my attention was first attracted by the idea that, for the solution of our problem, we ought to turn our attention to the sugar in normal urine, no very exact tests for sugar were possible. The reactions were not very sensitive, the fact being that the surest evidence of the presence of sugar was obtained not from the reduction processes but from the method used by BrÜcker for preparing a potassium compound of sugar.

Every investigation which I undertook in his times for the confirmation of my theory was very arduous. The few cases which I at first had under observation presented formidable difficulties. The occasion of my first turning my attention to sugar in the urine was a case of a woman who had borne five children, and, after violent and continuous mental excitement, was suddenly seized with diabetes mellitus. I frequently examined her urine, and always found an abnormal amount of sugar. She had twice given birth to children whilst suffering from diabetes, and on each occasion the child was a female. This fact struck me, because previously, whilst she was strong and well, she had borne sons only. But, on the appearance of the disease mentioned, she had two daughters in succession, of whom the first one lived and the other was still-born.

I numbered amongst my acquaintances a family, of whom, in the course of years, I was acquainted with the grandmother, a daughter, and two grand-daughters. The grandmother had, including the third generation, fifteen descendants, of whom twelve were girls and three were boys. Two of the boys were the sons of the grandmother, and the first two children she had borne. She was under medical treatment, and the analysis of the urine showed a considerable quantity of sugar. She had six daughters. One of these daughters, who survived the others, had five children, amongst them one boy, who soon died.

Two of the grand-daughters of this family became mothers, each bearing one daughter. I had the opportunity of examining the urine of all the mothers of this family, and always found sugar in it. Sometimes the saccharine contents reached a remarkable quantity, and yet were not such as could be diagnosed to indicate an unhealthy condition.

Amongst the acquaintances of my youth was a young lady of good family. Carefully reared, she was, as a child, too much sheltered from the influences of the open air, and in later years much imprisoned in-doors by hard study in different branches of art and science. As a young lady she was fairly tall and well nourished, but pale and possessed of little color.

It happened that I had an opportunity of examining this young lady’s urine. As I found a considerable quantity of sugar, I was led to the conclusion that the girl (she was engaged) would have principally female offspring.

Many years had elapsed. The young lady had ripened into a stately matron, and told me that she had the happiness to be the mother of five daughters and a son. I am altogether without the statistics necessary to deduce from a great number of similar cases the average relative number of the sexes born of women suffering from diabetes. But this must be pointed out, that, notwithstanding the high percentage of sugar excreted in the case of women suffering from pronounced diabetes, female offspring do not necessarily always appear. They will probably be in a very striking majority when compared with the males, but the complete disappearance of the male sex is not to be anticipated, because male individuals, though in the minority, can appear. And this was to be anticipated, seeing that in the so-called slighter cases of this complaint the abnormal metabolism can be sensibly improved by attention to diet.

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Diabetes amongst women has a marked influence upon the functions of the sexual organs. Thus, for example, the menses cease, a condition which, according to gynÆcologists, is occasioned by an abnormal condition of the womb and of the ovaries which become atrophied. (Schauta.) On the other hand, diabetes may also result from diseases of the reproductive organs. (Imlach.) When the cause of the complaint is removed from the female genitals the sugar also disappears from the urine.

From both of these facts, which rest upon medical observation, it follows that the excretion of sugar has some definite connection with the processes at work in the female generative organs. In the cases when the excretion of sugar continues for a considerable time, it is of greater significance, and indicates chronic derangement of the metabolism, in connection with which a serious change comes over the internal organs of generation.

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Now, if there is a possibility that disturbances so extensive can be set up in the female genital tract when there is an excretion of sugar, it is also very possible that certain modifications may be produced by a small constant excretion of sugar. These changes can show themselves in the ovum to this extent, that they may be of considerable significance and not without influence upon the development of sex.

Women who suffer from pronounced diabetes frequently miscarry. In what way the disease influences ovulation I cannot here discuss.

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The connection of the development of sex with an imperfect physiological combustion of the food can only be considered as demonstrated, if it is possible, by means of certain exact experiments in this direction to reach results which incontestably make for the possibility of influencing sex. Cases of this kind, in which the work of observation was conducted by myself alone, and in families closely connected with me, where there were exceptional wishes in this direction, I shall mention presently.

Most striking of all are the cases where a number of daughters have come into the world one after another as the results of a marriage.

The condition of a woman in a well-regulated married state, when, as we will suppose, five or six girls are born, one after another, must be considered to be of a kind that departs more or less from the normal. The human female, if we regard the general statistical data, ought to bring forth approximately the same number of male and female individuals. If we find so remarkable an excess in the direction either of males or females, that six or seven of the same sex follow one another, there must be a reason for this. In my opinion that cause is now to be ascertained only from the results of analysis of the urine for sugar, mentioned above.

In the cases where we have to deal with an excessive predominance of female offspring, Trommer’s test will show us the presence of sugar. But it is safest, as I have already said, to use the phenylhydrazin test in the manner described. If it be demonstrated that in any such case sugar practically exists in the urine, in never so small a quantity, dietetic treatment is to be resorted to, until even the minutest trace of sugar has been made to disappear.

The treatment consists in giving the mother a highly nitrogenous diet with fat, and adding only so much carbo-hydrate as is absolutely necessary to prevent its want being felt.

This diet should be continued for a considerable time, even although the sugar in the urine may have disappeared. It is best to begin the change of diet a good while (about 2 or 3 months) before impregnation. During the menstruations which fall within this period, the ripened ova will be voided unfertilized, and new ova which have been influenced by the altered conditions of nutrition in the organism will ripen in their place.

(If we follow such information as we have concerning the development of sex in man, we thence conclude that the difference in sex appears at the beginning of the third month of pregnancy, and is definitely expressed in the fourth month. From this it would appear not to be superfluous if the recommended alteration of diet was maintained until the beginning of the third month.)

When the ovule of a human female, dieted in this way, becomes fertilized, it has been so far ripened by the process of nutrition conducted in the organism of the mother, that when it attains the stage of development, it resolves itself into cells which compose an organism containing male characteristics.

After impregnation it is still advantageous that whilst the condition of the urine is examined at intervals of a few days, the corresponding diet should be continued during the advancing stages of the development.

Although I do not here take the trouble to illustrate these diet processes by explanations, every one can have regard to these particulars for himself, and conduct the diet even after impregnation has taken place in accordance with the information given above.

In a case like that mentioned, where, after marriage, female ova were successively formed and developed, practically a process of physiological combustion was going on in the mother which did not suffice for deriving all the advantage possible from the food, so that the available elements might be all oxidized. In consequence, only female ova were fertilized and only female individuals born. This condition of things remained the same for a number of years.

In such a case the question is not alone one of a small residuum of sugar, but in addition to this it is probably not impossible that other substances also were evacuated from the body, to make use of which was not within the power of the process of combustion.

With a rational diet, these substances also might be withheld from evacuation and, as well as the sugar, be made available for combustion with a corresponding increase of nourishment.

In experiments of this kind metabolic activity will show itself in the organism, as it may be perceived from the nitrogenous constituents of the urine that a greater exchange of nutritive matter is taking place, a thing that happens also with normal individuals.

Under these circumstances the specific gravity of the urine is also increased, and it may sometimes become relatively considerable (1030 to 1035).

In consequence of the influence which the altered diet, if commenced a sufficiently long time before conception, exerts both over the mother and over the ovum which is being prepared for fertilization, it is possible that this ovum may develop itself into a male individual.

It also sometimes happens that, even with careful dieting, the conditions which are necessary for our purpose are not realized—viz.: that the sugar does not disappear from the urine, that the mother cannot accommodate herself to a diet of the kind required. She finds the situation intolerable, because she cannot do without an abundance of starchy substances and sugar, and in consequence all hope of a satisfactory result falls to the ground.

There are persons who from their youth upwards have lived principally on vegetable food, and are therefore not accustomed to take the nitrogenous substances of their diet in the concentrated form in which they are presented in the albuminous constituent of meat. They obtain the necessary nitrogen for the body from large amounts of food containing a great quantity of water, and it may happen that they cannot easily submit themselves to such a change of diet without pernicious consequences. To this class belong the women who live in the rural districts of many of the mountainous regions of central Europe, where little flesh is eaten. With them it might often be a difficult matter to make an abrupt change of diet of the desired kind. Such individuals can be reconciled to the kind of diet we recommend only by a gradual advance in the quantity of concentrated nitrogenous food. But in such cases it might very likely prove possible to attain our end by a corresponding vegetable diet.

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The following case, which was conducted under my control with the greatest care, and was also a case of an intelligent woman, who showed the greatest willingness to do anything, in order that she might have male offspring, is of the highest interest for our theory.

This woman was of a family in which principally female children had been born. Although all its members were fruitful, no great number of descendants seemed to have been reached. It is not unlikely that the multiplication of descendants was restrained. The existence of a tendency to provide female ova for fertilization was also proved by testing the urine for sugar.

In the case of this woman, who wished to have male offspring, the examination of the urine each time showed, as with the other women of the family, traces of sugar. With her ordinary diet sugar was found in the urine (that of twenty-four hours being collected) in minute quantities. The unoxidized minute traces of sugar signified imperfect combustion.

When the diet is to be altered, it is necessary to select it in such a way that the nitrogenous substances may predominate and that the carbo-hydrates may be excluded as far as possible. Of course a sufficient quantity of fat must be added to the food.

The food to be taken was regulated on these principles, and the dieting began. After eight days the last traces of sugar in the urine had disappeared. The woman’s health was good, and she at once showed herself contented with the highly nitrogenous diet.

The menses lasted five days, and after them, five more days having elapsed, impregnation took place, the same diet continuing. After about eight weeks of pregnancy the food was gradually altered. The state of the woman’s health during pregnancy presented no remarkable features. She had taken all necessary care of herself, and her condition during the pregnancy, in like manner as before it, when she had to alter her diet until the sugar disappeared from the urine, was satisfactory. She was in due course confined of a boy.

A year and a half passed. The woman bore, after similar treatment as on the former occasion, a second boy. In the interval no further control was exercised over her way of living, but a few weeks before she conceived means were taken to regulate her diet, so that no perceptible trace of sugar resulted from its physiological combustion.

During five years this woman did not conceive. The results of examinations of the urine, which were made from time to time, showed quite clearly that sugar was always normally present. The quantity was not determined. At the end of this period the woman, after a long rest, and a similar preliminary dieting, once more became pregnant. This time also the result was a boy. After two years another boy followed. In this case also a similar process of dieting had preceded.

After such occurrences it was sufficiently demonstrated that it could be only the influence of the diet that showed itself in this way; because in this case one would be convinced that it was not a mere accident that the woman here spoken of produced only male offspring.

In the case of this woman it was evidently the diet that affected the development of sex, and exerted such an influence that, under the improved conditions, the metabolism both in the mother and in the ripening ovum preparing for fecundation, took such a form that a male individual was developed.

She again became pregnant after a lapse of two years. Before her pregnancy the same system of diet was followed as on the previous occasions. She miscarried in the fifth month. Violent emotions and mortifications, accompanied by anxious cares, were, together with other coincident unfavorable circumstances, the cause of the miscarriage. The offspring was male.

Soon after, some four months after the miscarriage, she again became pregnant. Also on this occasion dieting had preceded, such as I have frequently carried out for the development of a male individual. But a miscarriage again supervened. The foetus was obviously male.

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But what was now wanting was an experiment that could be added to the preceding, and would serve to show that a human female, who, under the influence of our method of dieting, invariably bore sons, would, in the case of paying no attention to diet, bring a female into the world.

The evidence was forthcoming, for the woman in question again became pregnant without any consideration being bestowed on her bodily condition, and without anything being done to remove the traces of sugar from the urine. After having seven times borne males she became this time mother of a female, which, born before the due time, soon died. After that she was not again pregnant. Probably some change supervened in consequence of which she became permanently unfruitful.

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This incident shows sufficiently that the ovum in the case of the woman who served for our experiment possessed an inherent tendency to develop into a female, and was also ripe enough to be fertilized. As we had exercised no influence upon it so as to effect any change in the ovum (in the same way as we had previously been able to affect the others by the diet in order to procure the ovum of a male) the result was a female.

The female tendency was therefore already present in the ovum, and indeed the mother supplied convincing evidence of the female constitution of the ovum whilst it was yet unfertilized, because sugar existed in her urine. The previous determination of the sex could also in this case present no difficulty. In the earlier cases, when male individuals followed one another, we always aimed, by means of our support given by means of the nourishment of the mother, not only at the ripening of the ovum which was to be fertilized, but also at the development of a male individual. In the last case the ovum was, without any assistance, capable of being fertilized, but it developed into a female.

A ripe, fertilizable ovum in the ovary of a woman whose urine habitually contains sugar has a tendency, when the proper conditions are supplied, to develop into a female. In consequence, it is in such cases from the outset possible, without exercising any influence over the mother, without adopting any diet, to anticipate after a conception, the birth of a female individual. But if these conditions do not exist, if no sugar can be detected in the urine, the use of the same influence in order to obtain a male individual is still not superfluous. In this case also there is a need of an alteration of diet, although the individual in question accomplishes the process of physiological combustion in a manner which must be called the most favorable possible, seeing that with a mixed diet all the oxidizable materials are completely used up.

Supposing that a mother of this sort wished for female offspring, one would not be in a position to give any advice. In this case one cannot, according to the facts which have been mentioned above, exercise any influence over an alteration in the course of the development of the ovum which would occasion the birth of a female. Such a mother is, up to the present time, beyond the reach of an influence that can affect the development of the future sex.

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Two other cases follow in which male children were desired, several females having so far been the offspring of the marriage. The corresponding arrangements for the regulation of the diet, which led to the complete disappearance of sugar from the urine, showed themselves effective in the ripening of the ovum, and, after conception had taken place, in both cases a male individual was formed and developed.

In addition to this, four other cases were under observation, in which no influence was exercised on sugar occurring in the urine in quantities, such as correspond to a normal healthy state. Without any kind of influence of diet, three females were born.

In a fourth case I had a negative result. In three cases the result was positive. In the last three cases I was able to examine the urine as often as I wished, whilst in one case I was allowed to do so only at long intervals as a favor.

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Let us now in conclusion endeavor to make some short reflections on the results which we are able to attain.

First of all one would say that in certain regions and among certain peoples, where meat forms the principal diet, only male, or principally male, offspring would be anticipated.

The nutrition of the mother certainly plays a leading part in the development of the ovum within her body. The different experiments which breeders have made, and the observations which have repeatedly shown in the case of the invertebrata (v. Berlepsch, ‘Die Biene und ihre Zucht,’ second edition; Landois, ‘Physiologie’), a connection between food and the development of sex leave no doubt that, in the case of the human subject also, a certain diet of the mother would not be without influence on the ovum developing within her. Here, however, in the case of the ripening of the ovum, according to my opinion, the result does not depend on the diet alone, but rather on the process of metabolism in the mother.

How the physiological combustion goes on in the organism, and what changes take place in it, in consequence of the altered diet, until the sugar entirely disappears, is in the case of human beings of the highest importance, and furnishes an index of the consequences.

In individual cases the diet is directed in accordance with the results that show how the food has been assimilated and does not depend upon these alone. In other words, whether the mother eats much meat is a secondary consideration. Whether and how the food taken is completely made use of in the process of combustion—that is a matter of importance for the purpose we have in view.

Any one, who keeps before him the fundamental principles of this theory, will see plainly that it is possible, under certain circumstances, to procure male progeny by means of the influence we have indicated. The wish to have female progeny is a desire for the gratification of which it is not at present possible to give any directions.

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In connection with all that I have already said I will here mention that the method which I employed to procure the ripening of an ovum for male progeny in cases where I had previously found sugar normally present, which served as an indication for the application of my treatment, I attempted to apply also in the case of individuals with whom no trace of sugar was to be found. The method of proceeding, judging by my experiences thus far, should be as follows.

First of all, it must be elicited whether any special disease exists, and especially any that indicates anomalies in the metabolism. Of course capacity for generation and the possibility of conception are presupposed.

If the history of the case shows no circumstances that would hinder the application of the method, we inform the patient that she must furnish us with the urine necessary for the occasional examination. It is best to use for this purpose a urine glass marked in grammes and containing two litres, in which the urine of twenty-four hours is to be collected.

It is well at the beginning of the procedure to put a few drops of formaline into the measuring-glass, so that the urine may not, in consequence of standing, decompose, and so become unfit for accurate analysis. Of the collected quantity of twenty-four hours, about 200 grammes should be poured into a small phial, well corked, and used for analysis. In making the analysis it is best to proceed in the following order: First, we determine the reaction of the urine with litmus paper. In normal urine the reaction is generally acid. Next the specific gravity is determined. This is most easily done with Ultzmann’s urometer, by means of which the density of the urine can be easily determined. That varies in normal urine generally between 1015 and 1020. In exceptional cases it may sink very low, which often happens after much fluid has been taken. In other cases it rises under pathological circumstances enormously high, as, for example, in diabetes. In the case of a thorough preparation of the organism by the use of a great quantity of concentrated nitrogenous food with a view to influencing sex, the specific gravity very often reaches 1030 and more.

After the specific gravity we measure next the quantity of urine collected in the twenty-four hours.

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We proceed next to determine the normal urine-sugar, and for this purpose use a number of the well-known tests—Nylander’s, the fermentation test, and Trommer’s test—which have been already described. If these give a positive result, we proceed to a quantitative examination by means of the polariscope. If the quantity of sugar found is very small, we exert ourselves to get rid of it by a suitable diet, because otherwise no certain influence over the embryo in the direction of the production of male offspring can be exercised. If, however, we find no sugar by any of the above tests, we seek for it by means of the phenylhydrazin test also described above. A few experiments on the melting point of the phenyl-glycosazon crystals will easily give us certain information. In the analysis we observe particularly whether the positive result of the phenylhydrazin test has originated from the sugar or from the reducing substances. With the polarization apparatus we determine the quantity of lÆvo-rotatory substances, the optical rotation, in per cents., as these stand in a certain relation to the reducing substances. We make these experiments with urine that has not been decolorized. The former becomes greater as the quantity of the latter increases.

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The determination of the reducing substances can be effected by Salkovski’s gravimetric method, but I prefer Moritz’s volumetric method, on account of its simplicity. For the experiment we prepare the following solutions: 1. A solution of sulphate of copper of 80.78 grammes Cu S O₄ + 5 H₂ O, in a litre; 2. Solution of caustic soda of 120 grammes Na H O, in a litre; 3. Watery solution of ammonia, of 7.1 per cent. N H₃, specific gravity 0.9722. For conducting the volumetric analysis we place in one of Erlenmayer’s flasks, containing about 250 cubic centimetres, about 2 cubic centimetres each of the soda solution and the solution of sulphate of copper, and add 140 cubic centimetres of the ammonia solution. We thus obtain a dark blue fluid, which we now boil. During the boiling we allow the urine to be analyzed to flow in from a burette until the fluid becomes colorless. A table given by Moritz in the forty-sixth volume of the ‘Archiv fÜr klinische Medizin,’ shows us in per cents. the quantity of reducing substances contained in the urine we have used.

In conclusion we investigate the condition of metabolism by determining the excreted nitrogen. Nitrogen is excreted both by the urine and the fÆces. The greater part is found in the urine, whilst, on the contrary, the quantity of nitrogen excreted in the fÆces amounts to more than 1 gramme per day. If, then, we determine the quantity in the urine alone and add 0.94 gramme as a correction for the nitrogen excreted with the fÆces, the resulting error will be unimportant. The best and at present most useful method of determining the nitrogen is that of Kjeldahl. I generally use it in my analyses as one that can be conveniently carried out. For this purpose we place 5 cubic centimetres of filtered urine in a long-necked flask, add about 3 decigrammes of yellow oxide of mercury and 10 cubic centimetres of chemically pure sulphuric acid. We then carefully warm the brownish-black mixture over the flame of a Bunsen burner until it has become colorless. We now allow it to cool. The mixture is now poured into an Erlenmayer flask containing three-quarters of a litre of water, is neutralized with 30 per cent. soda-lye, and then 40 cubic centimetres of a 4 per cent. solution of potassium sulphide is added. The whole is next subjected to distillation. Decinormal sulphuric acid contained in the receiver takes up the ammonia which distils over. The acid still remaining free after the completion of the distillation is titrated with decinormal caustic soda. As 1 cubic centimetre of decinormal sulphuric acid corresponds to 0.0014 gramme of nitrogen, we can easily reckon the quantity excreted daily. We know how much nitrogen is contained in 5 cubic centimetres of urine, and can easily find to how much the daily quantity amounts by multiplying by it and dividing by five.

The nitrogen found in the urine can be expressed as albumen by multiplying it by 6.25 (Neumeister), at the same time making a correction for the nitrogen in the fÆces as described above.

This is all that there is to say about the analysis of the urine, which is of so much importance for our experiments. In order to show the practical application, I will add the following analyses, as actually made in exercising an influence over sex to obtain male offspring.

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1. Case of a woman twenty-three years old, who, before anything was done to influence the sex of her offspring, had been married five years, and had given birth to two girls. The urine was collected from eight in the morning until the same hour of the next day in a measuring-glass. The quantity in twenty-four hours was 1,650 cubic centimetres. Analysis gave the following results:—

I recommended that more meat should be taken, and that sugar and other forms of carbo-hydrate should be avoided. After the lapse of eight days, I again procured urine for examination. Analysis gave the following results:—

The result was that the reducing substances and the nitrogen (expressed as albumen) had increased. The diet of this woman was constantly altered in the direction of increasing the amount of albumen, until, after the lapse of about three weeks, the following results were obtained:—

The woman was kept in this condition four weeks. In the meantime menstruation took place. It lasted four days, during which time no change appeared in the analysis. An analysis was made every week. Another menstruation occurred, lasting four days, and impregnation took place six days later. After this the menses ceased. As I mentioned above, the sex of the embryo is already determined in the third month of pregnancy, for which reason I kept the patient under dietary influence up to that time. In the interim I made ten analyses at short intervals, the average results of which I shall now give.

When after 5 analyses the nitrogen (expressed as albumen) had reached its highest point, it fell suddenly. Some immediate experiments proved that it was necessary to give more carbo-hydrates and less albuminous food, in order to re-establish the previous relations.

The woman was subsequently allowed to follow whatever course she preferred, and bore a fine boy at full term.

The task still remains of examining many facts and theories already known which may apparently be contradictory to our teaching.

And here should be first of all taken into consideration the experiments in diet made by various stockbreeders (Bellingers, Wilkens, etc.). In them, however, the results of the analysis of the products of excretion are not given, and in particular there is no information respecting the combustible and useable sugar evacuated from the organism, or any other substances from the organism which might have been of importance for the evaluation of the food. It is possible that in experiments with diet, without reference to the excretion of sugar, the results may be sometimes in favor of the male and sometimes in favor of the female sex, upon which latter no active influence is exercised. Herr U. P., a nobleman resident in a country district of the Russian Baltic provinces, informed me by letter that in his herds the greater number of calves are born in February. The February calves are principally male. The cause in this case may be as follows:—Conception takes place in the May of the previous year. After having been kept some six months in the cow-houses, the beasts are turned into the spring meadows, and are impregnated at a period when metabolism is active in consequence of their altered mode of life. All the cows are in heat. The notable result obtained in the ensuing February may be explained as the consequence of the better physiological combustion of the food.

According to statistics more boys than girls are born in the years with a poor harvest. Bad harvest years are those which favor a flesh diet, as the food-stuffs from the vegetable kingdom do not suffice for the cattle, nor for the people either; in consequence of which the cattle are killed, and more flesh enters into the diet of the women who are fructified. If people in general had the normal aptness for procreation in such famine years, the flesh-diet might turn the scale in favor of the male sex; it being presupposed that the other conditions were fulfilled.

If Thury’s law be considered, Thury also held the ripeness of the ovum to be of importance for male or female ova. The ova were regarded by this author, as being more or less ripe, or as male and female, according to the time, whether it happened to be at the beginning or at the end of the rutting. To me, however, the ripeness seems to depend upon the process of physiological combustion in the organism of the mother. According to Thury no attention need be paid by us to the ripeness for fructification, as this ripeness is attained independently of our interference. But, on the other hand, our influence has the effect of producing a male ovum out of the ovule ready to be fructified.

If the dieting of a woman in the way we recommend is practicable and of definite effect upon the development of the future sex, we arrive at a conclusion which may be summed up as follows:—If a woman be dieted according to our method, she can reach a stage in which she becomes sexually superior to the man, and her offspring will then be male, in accordance with the law of the cross-heredity of sex.

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