226 ENDOCRINE GLANDS 



very pronounced. According to Jayle the loss of memory 

 is very common. Finally, following castration a real 

 psychosis may develop : hysterical attacks, erotism at the 

 time of the menses, acute mania, hallucinations, etc. 



These symptoms of artificial menopause last a variable 

 period of time. It is not uncommon to see them disappear 

 with or without treatment, but they may last, attenuated, 

 for several years. In some young women, they may dis- 

 appear and then return at the time when the menopause 

 would normally have occurred. 4 



All these changes following castration are not constant 

 and are not found in all cases. Certain surgeons, Segand, 

 Quenu, J. L. Faure, Delbte, do not believe in post opera- 

 tive menopause phenomena and consider them to be 

 insignificant and of no more importance than the natural 

 menopause. When they are found, they consist mainly 

 of waves of heat, slight nervous excitability and compatible 

 to a normal existence and susceptible of disappearing in 

 time. The severe cases are very rare and are only found 

 in very nervous women or in cases of hyperthyroidism. 

 They are exceptional in hypothyroidism, in which cases 

 the menses are late and the sexual phenomena are attenu- 

 ated. Sometimes these changes are more marked in 

 women nearing the menopause than in young women. 



For this reason the pathogenesis is very much in doubt. 

 Some writers refuse to believe that they are due to ovarian 

 insufficiency and are really indications of hyperthyroidism. 

 The suppression of the ovarian secretion, by disturbing 

 the glandular equilibrium, causes a complex syndrome in 

 which can be recognized, not only signs of thyroid hyper- 

 function, but also adrenal hyperf unction. The sclerosis, 



4 In general it can be stated that the younger the patient or the more stable 

 the nervous equilibrium, the less severe will be the manifestations of the artificial 

 climacteric. 



