THE FUNCTION OF THE OVARY apa 
The hemorrhages, usually considered as an indica- 
tion of hyperovarism, are realy due to luteal insuf- 
ficiency. Lack of this hormone commonly results in 
the excessive menstrual bleeding. When the ovarian 
factor predominates there are persistent and repeated 
hemorrhages with severe psychic disturbances. In 
such cases ovarian extracts, having coagulant prop- 
erties, are beneficial. 
Pharyngeal and oesophageal spasms are neurotic 
afflictions rather common during the climacteric, and 
ovarian insufficiency alone may be responsible for them. 
Among the psychic symptoms of the menopause the 
most common are melancholia, paranoia and manic- 
depressive states. While “the pathogeny of these 
symptoms is as obscure as anything in psychiatry,” ® 
the hyperfunction of the thyroid and adrenals has an 
important role. “Hysteria is influenced unfavorably 
in the earlier stages of the menopause, due to the en- 
docrine instability of this period. Later, when the 
ovarian function is definitely extinguished and the 
other glands which take part in the crisis have become 
stable, hysteria decreases or even disappears. Neuras- 
thenia stands in the same relation to the climacteric 
as hysteria.” § 
Many unusual conditions are connected with dys- 
function. According to Marafion: ‘Kraurosis vulva 
is directly dependent on ovarian insufficiency.” ° 
Angioneurotic edema, the adiposis dolorosa of Der- 
cum—all such conditions are believed to be ‘“‘endocrine- 
sympathetic alterations.” § 
Twice as many cases of gout develop between the 
ages of forty to fifty as at any other time. Therefore, 
gout is related chronologically to the menopause. It 
corresponds almost always to thyroid instability. As 
for chronic rheumatism, ovarian insufficiency predis- 
poses to it and the whole complex endocrine crisis of 
the menopause intensifies this predisposition. 
