SEXUAL PSYCHOSES AND NEUROSES 219 



in cases of great mental depression during menstrua- Psychoses as- 

 tion I have usually found thyroid extract to be most ftppaEeil tty 



hen efi rial normal men- 



* struation. 



The medicolegal point of view, especially in regard 



to kleptomania, is of great importance on the one 

 hand, lest an irresponsible person be unjustly punished, 

 and, on the other, lest advantage may be taken of the 

 difficulty in denning the extent of the influence of 

 menstruation. No harm would accrue from treating 

 women accused of criminal acts committed at this time 

 in the same way as those of tender age are treated when 

 detected breaking the law. 



An interesting discussion on this subject took place 

 at the Annual Meeting of the British Medical Association 

 in 1900. Among other important statements was that 

 of Wynn Westcott 1 , to which reference has already been 

 made (p. 207). 



A careful investigation biochemical and physical 

 should be made of every case in an endeavour to dis- 

 cover evidence which will suggest lines of treatment. 



The relation of menstrual disorders to psychoses has Psychoses as- 



,. -. , . . r ,1 r\ sociated with 



been discussed by a joint meeting of the Gynseco- mens truai 

 logical and Psychiatrical Sections of the Royal Society disorders. 

 of Medicine 2 . Ewart, opening the discussion from the 

 psychological point of view, favoured the existence of 

 true amenorrhceal insanity; but the general opinion, 

 expressed both by gynaecologists and by alienists, was 

 that amenorrhoea is a concomitant of insanity rather 

 than a causal factor in the disease. So, too, it may 

 be said that while dysmenorrhoea and menorrhagia 

 aggravate mental disturbances there is no evidence that 

 they initiate them. It has been found that when the 

 mental derangement is accentuated by menstrual dis- 

 orders the patient has a definite psychopathic family 

 history in about 82 per cent, of all cases. 



1 Westcott, W. Wynn, Brit. Med. Journ., 1900, vol. ii, p. 792. 



2 Ewart, C. T., and others, Proc. Roy. Soc. Med. (Obstet. and 

 Oyncecol Sect.), 1911, vol. v, p. 81. 



