THE SYMPATHETIC SYSTEM 233 



In artificial or natural menopause it cannot take the 

 place of the missing internal secretion, so that the results 

 are variable. Sometimes there is a temporary improve- 

 ment which only lasts as long as the medication is kept up ; 

 sometimes it is without effect. Furthermore, the vaso 

 motor or nervous phenomena coming on after removal of 

 the ovaries or at the menopause are really indications 

 of thyroid re-actions to ovarian insufficiency and are best 

 treated as such.' Hematoethyroidin or even extracts 

 of thyroid in very small doses, regulate the function of 

 the thyroid. 



In thyroid -ovarian insufficiency, ovarian extract alone 

 is often efficacious. Sometimes mixed ovarian and thyroid 

 medication or thyroid alone causes a marked improvement 

 in these cases. 



II. SYNDROMES OF OVARIAN HYPERFUNCTION. 



Women with hyperfunction of the ovaries have, accord- 

 ing to Dalche, certain characteristics. They are well 

 shaped, without excessive weight; they are pale; their 

 eyes are bright; the features very expressive and mobile. 

 They have a marked appearance of sexuality. 



This is sometimes appreciable in girls in which puberty 

 occurs early and is accompanied by hysterical attacks 

 sometimes re-occurring at each menstrual period. 



This condition is often hereditary. These women are 

 found to have begun to menstruate early, had many 

 children and a late menopause. The usual symptoms of 

 menstruation are exaggerated. The menses are abun- 

 dant from the first day on and last 8 or 10 days. There 

 is considerable pelvic congestion, which manifests itself 

 by a sensation of abdominal weight, cramps, desire to 

 urinate, hemorrhoids, painful breasts. The disposition 



