214 



THE SEX-COMPLEX 



Menopausal 

 psychoses. 



Changes in 

 the nervous 

 system 

 in hypo- 

 thyroidism. 



Menopausal 

 neuroses. 



but in most cases all that is necessary is the assurance 

 that such fears are unfounded. Nevertheless, we 

 occasionally see a complete mental change ; the patient 

 becomes melancholic and suspicious. As a rule, careful 

 management and suggestion will tide over the period of 

 uncertainty. If, however, a woman have a strong 

 psychopathic tendency she may become insane. Melan- 

 cholia, with ideas of persecution, is the most common 

 form of mental derangement. 



I have for many years treated all cases of mental 

 depression with thyroid extract, alone or in combination 

 with ovarian extract, and have found it most beneficial ; 

 ovarian extract alone is useless. This indicates, appar- 

 ently, that when the ovarian secretions are withdrawn 

 the thyroid also atrophies, and the loss of thyroiodin 

 leads to mental lethargy and physical adiposity. 



In connexion with this question of hypothyroidism, 

 the interesting work of Mott 1 and of Brun and Mott 2 , 

 must be mentioned. 



These investigators have found that in cases of 

 myxcedema the nerve- cells in the nervous system show 

 general chromatolysis of a subacute character. The 

 changes appear to affect the nuclei of the ninth and 

 tenth nerves, the cerebrospinal motor neurons, and the 

 sympathetic system. 



Local neuroses are not uncommon. Neuralgias, 

 functional paralyses and contractures, hyperaesthesias 

 and sleeplessness may occur, and are sometimes most 

 difficult to alleviate. Massage and autosuggestion are 

 probably the most useful methods of treatment in 

 severe cases. Sedatives and alcohol should be avoided. 

 General specific treatment of the nervous disorders of 

 the menopause is impossible until we are aware of the 

 exact etiological factors concerned. Bromides have 

 been extensively prescribed, but in my opinion they 

 are almost valueless, if not actually harmful. 



1 Mott, F. W., Congres Internal. deMed., 1907, Sect, vii, fasc. i, p. 111. 



2 Brun, R,and F. W. Mott, Proc. Roy. Soc. Med. (Sect. Psychiat.), 

 1913, vol. vi, p. 75. 



