216 



THE SEX-COMPLEX 



character 

 istics. 



The secondary to the primary changes in the other organs 



otm^uiSe °* internal secretion which are responsible for the 

 development of masculinity. 



In this connexion, I have been interested to hear 

 from Professor Wood Jones that he has observed that 

 many female lunatics are endowed with certain mas- 

 culine secondary characteristics. 



Disturbances 

 associated 

 with men- 

 struation. 



Menstrual 

 psychoses. 



Disturbances associated with Menstruation. — 

 Apart from the direct effects, to which reference has 

 just been made, of excessive or insufficient ovarian 

 secretion, we must take into account the metabolic 

 disturbances during menstruation, which may be so 

 extensive as to affect the mind of the patient. Exactly 

 what the anomalies are we do not always know, but it 

 is probable that mental disturbances of an active 

 or hysterical nature are due in part to an excessive 

 excretion of calcium salts. And there may sometimes 

 be a recognizable disturbance of the internal secretory 

 system, especially in connexion with thyroid. 



In addition to the effects primary mental diseases may 

 have on menstruation, which will be mentioned directly, 

 it is well recognized that various mental derangements 

 may occur both as the result of disturbances of 

 menstruation and in association with the otherwise 

 apparently normal catamenia. 



Before attempting to specify the various conditions 

 observed I must again emphasize the fact that both 

 the manifestations and the prognosis are worse in 

 a person who has a neuropathic family history ; indeed, 

 it is generally difficult in these circumstances to say 

 whether menstruation or some special disorder of this 

 function is the cause of the condition, or whether it 

 has only precipitated the attack or aggravated the 

 mental instability of the patient, in the same way as 

 an attack of true epilepsy may be excited. Neverthe- 

 less, it appears probable that certain psychoses may be 

 initiated as well as aggravated by menstruation or some 

 disorder of this function. 



