chanp.:e of life: but it r.,: y 1 Is Foth.ng. to do with the meno The nervous system feels the in • • (if these altered conditions, and ndcricy continues until she L.,ets .r) hcr new relations with her sur and acquires new interests.
General Symptoms.—The disorders of a are divisible into two g-eneral N hich are subdivisible into sev (.1 thPse. it is necessary to recog n:zr. -Emetically, a third division:— M. Complications, or disorders inci dent to the period of life during which the menopause occurs.
DisonDEus OF TEE CIRCULATION.— Flushes.—When flashes, or flushes, occur the blood rushes suddenly to the surface of the body, particularly to the face and neck, causing a violent burning and ting ling sensation and a high color, followed in a few minntes by a free and distress ing perspiration. These phenomena are best observed in vigorous young women from whom the ovaries have been re moved, for in them the flashes often come on within two or three weeks of the operation, and continue for several months, or even for over a year. They may recur as often as once in fifteen minutes, but generally the intervals are somewhat longer. After six or eight weeks the flashes become less frequent, without diminishing much in violence, and finally they diminish both in fre quency and intensity, until they cease to recur.
[The following description of her sen sations is written by a very intelligent young lady, from whom the tubes and ovaries were removed eighteen months previously, for a, small fibroid of the uterus, with retroversion and incarcera tion. The tumor in the uterus has di minished in size during the interval of time, and the uterus is held in proper position b:!,- ventrofixation.
"I am afflicted regularly with 'flashes' at intervals of from 40 to 50 minutes, day and night. They are sometimes pre ceded by slight faintness or chill: then, again, with dizzy feeling, or slight head ache. I can almost feel myself turning pale. when it seems that the blood is leaving every part of body; so noticeable is it that just previous to a 'flash' I have been asked `Are you cold?"Are you faint?' or 'Are you ill?' "In a few seconds, however, a sort of resigned feeling unconsciously tak-es pos session of me, when suddenly a wave of heat rushes over face, arms. and upper part of body, face and hands turn a most uncomfortable red color; soon the heart beats very hard, and 1 can almost hear it thumping, Soon beads of moisture be gin to stand out on my forehead, chin, neck, at joining of lower and. upper arms, and on bosom, after which the heat per meates the lower part of body, to my toes.
"When a 'flash' is preceded by drowsi ness, for some few seconds I can scarcely keep my eyes open—seem to be as in a dream, and arms and legs feel heavy.
When preceded by a chill, hands and feet feel cold. Always before 'flash' my throat feels parched, and I am very thirsty. 'Flashes' seem to be more severe after a hearty meal." E. W. Cusitm0.1 In the physiological menopause the same flashes are observed, although, usually, they are much less violent; they are also apt to last rather longer, some times for two years or more. Although these are usnally classified as disturb ances of the circulation, they are prop erly nervous phenomena. The vascular system merely responds to the stimulus which causes blushing under emotion, and is not in itself disordered at all. The whole subject, therefore, might be included properly under the disorders of the nervous system.
Hemorrhages.— Perhaps the same might be said about the sudden attacks of haemorrhage which sometimes occur at about the time of the menopause, just as they do at puberty, and, indeed, occa sionally at all periods of the sexual life of woman.
So many cases have been reported that it must be admitted that such lilemor rhages really occur at the menopause, merely as a result of vasomotor disturb ances, and without any appreciable dis ease of the uterus.
Nevertheless, a vigilant and painstak ing skepticism should be the rnle, for usually some complication will be fonnd which will account for the haemorrhages, especially if they are repeated and recur at intervals covering a considerable space of time. The apathy and credulity with which the women attribute these lutunor rhages to the change of life are only the result of the false teaching of the pro fession at times when the pathology of uterine diseases was not understood. Many a valuable life iS lost because flow at this time is attributed to the climac teric, when really there is grave organic disease present and progressing.
Personal observations based on 373 eases. Assuming, that the normal men opause occurs between the ages of forty five and fifty years, it was found that in 130 women the climacteric atrophy of the internal genitals was present to() early. In 40 menstruation did not cease until after fifty years; 13 were fertile at forty-five years and over. Senile en dometritis was noted in 7 eases. In 4 women between the ages of fifty-eight and seventy-one years, who had always enjoyed good health since the meno pause, metrorrImgia appeared, due, ap parently, to calcification of the uterine vessels, since no other cause could be assigned. Kleinwachter (Centralh. Gyraik., -No. 20. 1002).