THE FUNCTION OF THE OVARY 223 



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," 8 

 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." 8 



Many unusual conditions are connected with dys- 

 function. According to Maranon: "Kraurosis vulva 

 is directly dependent on ovarian insufficiency." 8 



Angioneurotic edema, the adiposis dolor osa of Der- 

 cum all such conditions are believed to be "endocrine- 

 sympathetic alterations." 8 



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. 



