DISORDERS OF THE NERVOUS SYSTEM. —"Palpitations." — The symptoms of "palpitation of the heart" and of attacks of syncope from which NV0111011 suffer at the time of the climacteric arc quite similar both in kind and degree to those with which a certain proportion of women of all ag-es are troubled. The only feature peculiar to the change of life is that women often present these symptoms at that period who have not been troubled in this way during, their previous rears, and who certainly have no or,,c2;anic lesion of the heart. Like the flushing and the uterine limmorrliages mentioned ahove, these symptoms are to be understood as disturbances of regula tion, not as diseases.
IT yslero-elisturbances and Psychical Disturhanres.—Thes.o plymoinena do not r tit ):.0 NS affect•. I r.t.11 W0111011 at other t r the only peculiarity • - attack women • ‘I beell free from such P• ',.• IL; N....1 7.i.t. tlitrefore, be necessary to .r.i.e :I e Narions symptoms and varie . liN,Itrical and hysterico-ne.urotic J7, ..11, the alterations in temper 2 : I? .? r..inc111, ranging all the way 'r t melaneholy. which may • SS In( 11 at this change of their - \\Tat 's desirable to know is why 1...uritances should affect some this time and not others, and h r am-thin,: can be done to relieve I •• quite evident that at the meno Wi haw to do with two processes: • t 0.• (..‘,..ation of function of the ova an I f the menstruation, which is ,,_c-napaniment of such function; tl.t involution of the uterus, which :.• :„ 1.-r should go on, pari passu with l.n.inution of ovarian activity. The Eris f women who suffer from hys t. r:,_m! and nervous disorders at the r n•-• and those of women who • fr,m hyperinvolution or from insufficient development of it.,rus are very similar, and careful ly in•lividual cases has led me to tl at the disturbances of the f..wi • ,.r are largely due to want of proper 7 1 n :n fine or in amount between • d.m:nut;. n (1 functional activity and :,,-(.1.,•;(r) of the ovaries and of the W1J-n the function of the ovaries
..) suddenly for the uterus, or • rw:ng, to congestion, endome polyri, small fibroids, or other ,,s uterus cannot underao in -I.:in concurrently with the ovarv, and ha-morrhages follow, com plicated with the general train of toms witnessed after surgical removal of the ovaries.
lltemorrhage is not a necessary con comitant of the menopause. When it does occur, other than a metrorrlaagia in the true sense of that term, it is in 95 per cent. of the eases significant of a pathological condition. During the past three years 4S2 healthy women over 52 years of age have been interrogated. Of these only 39 gave a history of what could be termed a hmmorrhage during tbe menopause, and out of this number only 5 gave a history of hmrnorrhage of any persistency. In 287 tabulated pa tients, between 43 and 50 years of age, suffering from uterine hTmorrhage, 19 were due to pregnancy, 4S to malignant disease, 53 to fibroids or uterine cysts, 10 to diseased endometrium, 26 to diseased appendages, while in 31 no positive diag nosis was made. All persistent hmmor rbages during menopause should be re garded with suspicion. John Duff (Jour. Amer. Med. Assoc., Oct. 21, '99).
When, on the other hand, the uterus tends to cease its functions sooner than the ovary, stimulation originating from the latter to continue menstruation gives rise to a set of symptoms similarto those witnessed in cases of hyperinvolution of the uterus after childbed or prolonged lactation or exhausting diseases; or in cases of undeveloped uterus, where after puberty the infantile condition of that organ remains, while the ovaries develop fully.
Atresia of the uterus after the meno pause occurs pathologically much niore frequently than is supposed. The atresia is physiological only after complete atrophy of the body of the uterus and its endometrium. Tbe symptoms of the condition mislead by directing attention to the nervous system more particularly than to the true seat of disease. H. L. E Johnson (Jour. Amer. Med. Assoc., Dec. 7, '95).