SEXUAL PSYCHOSES AND NEUROSES 217 



In a consideration of the subject it is advisable, as Menstrual 

 indicated above, not to limit too closely our discussion psyc 08es * 

 to psychoses which occur only during menstruation (the 

 ' psychosis menstrualis ' of Krafft-Ebing), but also to 

 include those which may be supposed to depend on 

 some disturbance of this function, such as amenorrhcea. 

 Many authors include in the term * menstrual psychosis ' 

 the mental derangements seen at puberty and the meno- 

 pause : such a classification is given by Konig 1 . But it 

 appears simpler to discuss the epochal psychoses under 

 the description of disorders of puberty and the meno- 

 pause, and to confine the term ' menstrual psychosis ' 

 to mental disturbance dependent on the cyclical occur- 

 rence of menstruation or some anomaly of it. It is, 

 nevertheless, obvious that some psychoses of puberty 

 are exactly the same as those seen later in life, puberty 

 having been merely the starting-point of the exciting 

 cause — menstruation, 



Psvchoses occurring during menstruation are prob- Psychoses as- 



, , ■. • *. t f . sociated with 



ably very common, and may, as pointed out by apparently 

 Konig 1 , occur regularly at each menstrual period, or g^SSon? en " 

 only occasionally. Further, the seriousness of the 

 psychosis varies from a very slight alteration in tem- 

 perament to serious mental irresponsibility. 



The subject, considering its importance, is one that 

 has been greatly neglected by gynaecologists, and it has 

 been left to sexual psychologists to present the subject 

 in a somewhat unattractive form. 



It appears strange that women should not definitely 

 be freed from the psychical stigma of menstruation, or 

 be forced to accept the fact that menstruation may 

 produce mental disturbances which render them unfitted 

 for those strenuous masculine occupations which require 

 well-balanced mental judgments. Many women, of 

 course, are unaffected mentally by the occurrence of 

 menstruation ; many are affected in a minor, and some 

 in major degree. From a social and medicolegal point 

 of view the matter is of considerable importance. In 

 1 Konig, H., Berl. Klin. Woch. % 1912 vol hrix, p. 1645. 



