MENOPA1TSE, DISORDERS OF. General Considerations.All the or ganic diseases of various kinds begin to show their full effects at about 45 to 50 years. If a woman's organs are not all sound, she is apt to break down. at this age; on the other hand, if there are no organic disorders, abnormal condi tions do not develop, and the woman who was healthy before remains healthy throughout the climacteric period.
In women whose nutrition is uniformly approximated to the normal standard, and who reach this period unhampered by pre-existing ailments, the final cessa tion of menstruation occurs without ma terial disturbance of the functional har mony and is often of cosmetic advantage. The association of morbid conditions with the menopause is accidental and the re sult, usually, of antecedent causes, espe cially of unphysiological living. The in fluence of perfect nutrition and natural living during the premenstrual and ado lescent years upon the after-life of women is of the most salutary and far-reaching kind. A. H. Bigg (Amer. Medico-Surg-. Bull., Jan., '93).
The menopause is a diverted trophic nervo-vascular force, a readjustment of nutritive forces, not life-endangering in itself. J. S. _Nowlin (Nashville Jour. of Med. and Surg., Jan., '95).
The various malignant diseases, which are prone to show themselves at about the time of the change of life, are often attributed to menopause as an entity; but, in truth, the vitality with which we are endowed is always diminishing, the reserve force is lessening, and at an age varying from 45 to 55 years there is very little margin to draw upon. This is not confined to women, however, for it is seen in the fact that men are not ac cepted for enlistment above the age of forty-five, while at sixty they may also be said to undergo a "change of life." The menopause, properly speaking, is only one feature of the change of life. The woman is no longer strong enough to bear and rear children, except in com paratively few cases. She has not the vitality to endure the continually re curring drain of menstruation. and this function ceases at about the end of the ninth lustrum, varying much according to race and climate.
Series of 250 cases studied as regard.s the age at which menopause takes place. It occurred in 2 women aged 37, in 2 aged 3S, 3 at 39, 12 at 40, 3 at 41, 11 at 42, 6 at 43, and S at 44. Beyond the nor mal ages the change came on in 3 pa tients at 54, and in the same number at 55, and in 1 at 56, and the same number in patients of the age of 57. 58, and 59, respectively. Parviainen aus der Klinik der Prof. Engstein," vol. i, Part II, '97).
Cases of early menopause may be con founded with transitory superinvolution of the uterus, associated with amenor rlicea and climacteric signs and symp toms. :McCann (Univ. Mcd. Mag., Mar., '98).
The disorders of the menopause, per se, are really only those which arc in some way connected with the cessation of menstruation, and they are compara tively few and simple; while the disor ders and symptoms occurring at the period of the change of life or grand climacteric in either sex, hut especially in woman, are many and v2rious, and often very severe.
Of late years the frequency of opera tions for the removal of the ovaries has caused the subject of the sudden and artificial menopause thus brought about to assume great importance, and. as its symptoms and its disorders ea n be ,L.- tot Ilt :SIDI:110111S of ad /C .41. ro,rt. e disease, I. a. thrOWn On 1 , I 'IL the 1114 nopause proper by .14, LL-torr of the symptoms Z. 7: post-operative menopause.
tt afflict:ens which are ens ,. N;zri. !wad to menopause are tl r ous manifestations, r tunperament, and it tntal condition. But here, . .1 t.arv to discriminate be : cl I.at due to the cessation of t.n. and all the woes that :7 dn. life of so many mid incn. For. at this period, P N ..11ht are profoundly unhappy, ? it..1 with. au reason. Beauty fades, v t..1.(,e and gray, and feel their 611:, zkt'. their social relations. Above 1_,: :s the feeling that there is no T.-.. _r s:.here of activity left for them. ti,,y e 1,0 business, as men have, to :1 y attention. A woman very y 1.as no interests which really ? I..tr and give her an aim in life. .