222 THE SEX-COMPLEX 



Menstrual following thyroid-parathyroidectomy can be controlled 

 by the intravenous infusion of calcium salts. Litteljohn 1 , 

 of the Hanwell Asylum, also, has found that fits of true 

 epileptics, which occur in female patients so much more 

 frequently during menstruation, can be checked to an 

 astonishing degree by the administration of calcium 

 compounds. Since my original observations I have 

 treated successfully with calcium salts many other 

 cases. 



When, however, there is no menstruation owing to 

 the absence or underdevelopment of the uterus, the 

 condition is precipitated solely by cyclical ovarian 

 activity. If the uterus be slightly undeveloped, and 

 the patient be under 18 years of age, as in a case 

 under my care recently, an attempt should be made to 

 find the cause of the underdevelopment and to treat the 

 case accordingly. Often it will be found that hypo- 

 thyroidism is the primary cause of the underdevelopment 

 of the uterus. When the uterus is absent or rudimentary, 

 probably the best treatment may be to remove all but 

 a small portion of one ovary. Lockyer 2 successfully 

 treated one patient, whose condition was serious, by the 

 complete removal of both ovaries. 



Reproductive Disturbances associated with gestation, the 

 puerperium and lactation. — During pregnancy the 

 mental attitude rarely undergoes profound alterations, 

 but in nearly all cases it is normally affected to 

 some slight extent. How far this is due to fcetal 

 hormones, and how far to changes in the metabolism 

 it is somewhat difficult to estimate. Apparently, the 

 normal mental change is towards quietness and resigna- 

 tion, and if this be exceeded melancholia may supervene. 

 Extract of the thyroid gland is most beneficial in these 

 circumstances, hence it may be presumed that normally 

 this organ is taxed to the fullest extent, and that some- 

 times it may partly fail in the supply of its internal 

 secretion. 



1 Litteljohn, A. R., Lancet, 1909, vol. i, p. 1382. 



2 Lockyer, C, Trans. Obstet. Soc, 1906, vol. xlviii, p. 75. 



insanity. 



