172 THE SEX-COMPLEX 



Effects of scientific distinction, which undoubtedly exists and 



ectomy accounts for the individual variations to be observed 



tode rt e n f te a * ter oophorectomy, be made, it does not seem right 



femininity, blindly and systematically to remove the genital 



glands as some operators do in the circumstances 



mentioned. 



I do not think the explanation I have given of 

 individual variability with respect to the disturbances 

 following oophorectomy has been suggested before ; but 

 there can hardly be any doubt that the symptoms pro- 

 duced by oophorectomy in any given case are directly 

 proportionate to the degree of femininity. 



Since the natural menopause bears a close resemblance 

 to the artificial, I shall briefly discuss together the 

 disturbances which may be associated with either. 

 Causes of the It is more or less generally supposed that the natural 

 nopause. menO p ause occurs in women as the result of the gradual 

 withdrawal of the ovarian secretion ; and it is, of course, 

 certain that the artificial menopause is produced by the 

 absence of it. At the natural or physiological meno- 

 pause there is undoubtedly ovarian insufficiency sooner 

 or later ; but, as with the artificial menopause, it has 

 always seemed to me that the symptoms produced 

 depend for their severity upon the correlations that 

 exist between all the internal secretions, on the uterine 

 changes which prevent the monthly excretions, and, 

 lastly, on individual variability in regard to repro- 

 ductive activity and to the stability of and capacity 

 for readjustment in the cryptorrhceic system. That the 

 phenomena associated with the physiological menopause 

 depend partly on ovarian insufficiency is demonstrated 

 by the onset of similar manifestations in most women 

 after oophorectomy ; and that they are related to the 

 coincidental uterine atrophy is proved by the fact that 

 women may suffer with the same symptoms after the 

 removal of the uterus alone. Further, I have seen 

 monthly molimina, which reminded me of some of the 

 symptoms of the menopause, in women in whom there 

 was congenital absence of the uterus, or malformations 



