THE MENOPAUSE 
OR 
CHANGE OF LIFE 
WOMAN'S CRITICAL AGE 
ITS DANGERS AND DISORDERS 
THEIR PREVENTION AND 
TREATMENT 
BY 
WILLIAM J. ROBINSON, M. D. 
Chief of the Department of Genito-Urinary Diseases and Dermatology, Bronx 
Hospital and Dispensary; Editor of "The Critic and Guide;" Author of: 
Treatment of Sexual Impotence and Other Sexual Disorders in Men 
and Women; Treatment of Gonorrhea; Woman, Her Sex and Love 
Life; Married Life and Happiness; Sexual Problems of Today; Sex 
Knowledge for Men and Boys; Birth Control or the Limitation 
of Offspring; Never Told Tales; Stories of Love and Life; 
A Clergyman's Son and Daughter; Eugenics and Marriage; 
Sex Knowledge for Women and Girls; Sex-Morality-Past, 
Present and Future; Sexual Truths; Prescription In- 
compatibilities, etc.; Ex-President of the Berlin Anglo- 
American Medical Society, Fellow of the New York 
Academy of Medicine; Fellow of the American 
Medical Association; Member of the New York 
State Medical Society, Medical Society of the 
County of New York, Harlem Medical Asso- 
ciation, American Medical Editors' Associa- 
tion, American Urological Association, In- 
ternationale Gesellschaft fur Sexual- 
forschung, British Society for the 
Study of Sex Psychology, Ameri- 
can Association for the Advance- 
ment of Science, etc., etc. 
1923 
Critic and Guide Company 
12 Mount Morris Park West 
New York Copyright, 1923 
By William J. Robinson,, M. D. PREFACE 
The author has been told by a num- 
ber of readers that his book, "Woman: 
Her Sex and Love Life," deals most sa- 
tisfactorily with the problems of wo- 
man's sex life-with one exception. The 
chapter on the menopause, woman's 
critical and dangerous age, is too brief, 
too condensed. I grant that. But, while 
woman's sex life does not end, as will be 
clearly shown in this book, with the 
menopause, the most active, or perhaps 
I should say, the most acute part of her 
sex and love life does. And the prim- 
ary object of "Woman: Her Sex and 
Love Life" is to deal with woman's most 
active period, the period from puberty to 
the menopause. But the latter, also re- 
ferred to as woman's critical or danger- 
ous age, is often truly critical and some- 
times dangerous. And it affects so many 
poor women,-and some very rich wo- 
men are poor indeed during their meno- 
pause years,-that a plain commonsense 
book pointing out its pitfalls, and giving 
both prophylactic and therapeutic ad- 
vice cannot but prove of value. 
5 I have no doubt that the general prac- 
titioner will find in the following pages 
many hints which will help him in hand- 
ling his climacteric patients; he will find 
it easier to relieve and to cure their real 
and imaginary troubles. 
And I am even optimistic enough to 
believe that a perusal of this book by 
intelligent women before the menopause 
will aid substantially in preventing many 
of its disorders; a study of it when the 
disorders or diseases have already made 
their appearance should help materially 
in their alleviation and cure. 
Lincoln's Birthday, 1923. W. J. R. 
12 Mount Morris Park West, N. Y. 
6 Pages 7-8 missing THE MENOPAUSE OR CHANGE OF LIFE 
Page 
PREFACE 5 
CONTENTS 9 
CHAPTER 1-WOMAN'S HEAVIER 
BURDEN. MENSTRUATION. PREG- 
NANCY. CHILDBIRTH. LACTA- 
TION. THE MENOPAUSE 15 
CHAPTER II-MY FIRST CASE OF 
MENOPAUSE TROUBLE. LACK OF 
INSTRUCTION IN SEXOLOGY IN 
MEDICAL SCHOOLS 18 
CHAPTER III-THE MENOPAUSE. 
THE MEANING OF THE TERM. 
THE AGE AT WHICH IT OCCURS. 
MENOPAUSE, CLIMACTERIC, CLI- 
MACTERIUM, DODGING YEARS. 
CONDITIONC THAT INFLUENCE 
THE AGE OF THE MENOPAUSE. 
EARLIEST AND LATEST AGES OF 
MENOPAUSE 22 
CHAPTER IV - SYMPTOMS OF 
MENOPAUSE. EXAGGERATED 
IDEAS OF MENOPAUSE TROUBLES 26 
CHAPTER V-USUAL SYMPTOMS 
OF THE MENOPAUSE. FLUSHES. 
IRREGULARITY IN THE MEN- 
STRUAL PERIODS. MENORRHA- 
GIA AND METRORRHAGIA. IRk 
RITABILITY. DEPRESSION. IN- 
DIGESTION. CONSTIPATION. 
CONTENTS 
9 Page 
CHANGES IN THE LIBIDO. OBES- 
ITY. VERTIGO. FAINTING. PAL- 
PITATION OF THE HEART. NOSE- 
BLEED. HEADACHE. NUMBNESS 
AND TINGLING. PRURITUS. IR- 
RITABILITY OF BLADDER. DER- 
MATOSES 29 
CHAPTER VI-THE PROPER ATTI- 
TUDE TOWARD THE MENO- 
PAUSE 36 
CHAPTER VII-THE ANATOMICAL 
CHANGES DURING AND AFTER 
MENOPAUSE. CHANGES IN THE 
OVARIES, THE UTERUS, THE VA- 
GINA, THE VULVA, THE MONS 
VENERIS, THE BREASTS, THE 
SKIN, THE HAIR 38 
CHAPTER VIII-CAN THE MENO- 
PAUSE CHANGES BE POSTPONED 
AND HOW? 42 
CHAPTER IX - SUDDEN MENO- 
PAUSE. ARTIFICIAL MENOPAUSE 44 
CHAPTER X-INCREASED SEXUAL 
LIBIDO DURING AND AFTER THE 
MENOPAUSE. THE CAUSES OF 
THE INCREASED LIBIDO 47 
CHAPTER XI-THE SURGICAL ME- 
NOPAUSE AND THE LIBIDO 51 
CHAPTER XII-THE HUSBAND AND 
THE MENOPAUSE. THE HUSBAND 
AS AN IMPORTANT FACTOR IN 
THE WIFE'S MENOPAUSE TROU- 
BLES 54 
10 Page 
CHAPTER XIII -THE MENOPAUSE 
AND IMAGINARY PREGNANCY... 60 
CHAPTER XIV-CANCER AND THE 
MENOPAUSE. CANCER OF THE 
UTERUS. CANCER OF THE BREAST 62 
CHAPTER XV-TREATMENT OF 
SOME OF THE SYMPTOMS OF THE 
MENOPAUSE. TREATMENT OF 
THE FLUSHES. TREATMENT OF 
FAINTING. TREATMENT OF 
NOSEBLEED 65 
CHAPTER XVI - THE MENOPAUSE 
AND INSOMNIA. TREATMENT OF 
THE INSOMNIA OF THE MENO- 
PAUSE 68 
CHAPTER XVII - TREATMENT OF 
THE INCREASED LIBIDO DURING 
THE MENOPAUSE 72 
CHAPTER XVIII-THE TREATMENT 
OF OBESITY OF THE MENOPAUSE 76 
CHAPTER XIX - TREATMENT OF 
CONSTIPATION DURING THE ME- 
NOPAUSE 80 
CHAPTER XX - TREATMENT OF 
WIND AND RUMBLING IN THE 
BOWELS 84 
CHAPTER XXI - TREATMENT OF 
ITCHING OF THE VULVA 86 
CHAPTER XXII-TREATMENT OF 
ECZEMA OF THE VULVA 93 
CHAPTER XXIII-THE TREATMENT 
OF LEUCORRHEA OR WHITES 
DURING THE MENOPAUSE 95 
11 Page 
CHAPTER XXIV-THE TREATMENT 
OF BAD ODOR FROM THE MOUTH 98 
CHAPTER XXV-LOSS OF HAIR AND 
ITS TREATMENT 101 
CHAPTER XXVI-TREATMENT OF 
HEMORRHOIDS 103 
CHAPTER XXVII-OFFENSIVE PER- 
SPIRATION AND ITS TREATMENT 106 
CHAPTER XXVIII-TYPE CASES ... 108 
CHAPTER XXIX-AVERAGE CASES 117 
CHAPTER XXX-THE MENOPAUSE 
AND SERENITY. THE MENO- 
PAUSE, SEXUAL AVERSION AND 
RETURN TO NORMAL. THE ME- 
NOPAUSE AND THE SEXUAL END 120 
CHAPTER XXXI-THE MENOPAUSE 
AND MENSTRUATION 124 
CHAPTER XXXII-THE MENOPAUSE 
AND ABNORMAL LIBIDO 127 
CHAPTER XXXIII - THE MENO- 
PAUSE AND FREE SEXUAL LIFE. 
THE MENOPAUSE AND ELOPE- 
MENT 129 
CHAPTER XXXIV - THE MENO- 
PAUSE AND JEALOUSY 132 
CHAPTER XXXV-THE MENOPAUSE 
AND HOMOSEXUALITY 137 
CHAPTER XXXVI - THE MENO- 
PAUSE AND RESTLESSNESS 139 
CHAPTER XXXVII - THE MENO- 
PAUSE AND MELANCHOLIA 142 
CHAPTER XXXVIII - THE MENO- 
PAUSE AND KLEPTOMANIA .... 145 
12 Page 
CHAPTER XXXIX - THE MENO- 
PAUSE AND PERSECUTION OF 
MEN u 146 
CHAPTER XL -THE MENOPAUSE, 
INSOMNIA AND SUICIDE 152 
CHAPTER XLI -MISCELLANEOUS 
CASES 154 
CHAPTER XLH - QUESTIONS AND 
ANSWERS. Menopause and Sexual End. 
Menopause and Cancer. Menstruation 
After Fifty. Menstruation After 
57. Return of Menses. Pregnancy Af- 
ter Menopause. Vicarious Menstruation. 
Removal of Ovary. Removal of Ovaries 
and Menopause. Removal of Ovaries and 
Sexual Desire. Obesity and Menopause. 
Menopause Induced by Shock. Length 
of Woman's Sexual Life. Heart Disease 
and the Menopause. Flushes of the Meno- 
pause. Thyroid in Obesity. The Meno- 
pause and High Blood Pressure. High 
Blood Pressure Due to Organic Cause. 
Cessation of Menses and Shock. Objec- 
tive and Subjective Vertigo. Vertigo and 
High Blood Pressure. Highest Degrees 
of Blood Pressure. Menopause and 
Mumps. Treatment for High Blood Pres- 
sure. Wet Cupping and Hot Flushes. 
Dosage of Corpus Luteum 157 
EPILOGUE 171 
INDEX 175 
13 CHAPTER I. 
Woman's Heavier Burden 
Let us not blink facts; let us look them 
straight in the face. And if we do look 
facts in the face we are forced to ac- 
knowledge that compared with man, wo- 
man has, sexually, been given a raw deal 
(with apologies for the slangy but ex- 
pressive phrase) by Nature. Nature, 
falsely and parrotically spoken of as 
wise and just, has, in dealing with wo- 
man, been neither wise nor just. 
Up to puberty, woman is on about the 
same level with man; she has it neither 
better nor worse. But beginning with 
puberty, with her first menstruation, and 
ending with her last period, and for sev- 
eral years beyond, she has in every re- 
spect a much harder time than man. 
Even where menstruation is in every 
way ideal, it is not a pleasant phenom- 
enon. It is a nuisance at best. It in- 
volves a certain amount of trouble, it 
15 woman's heavier burden 
prevents the woman from participating 
in certain events and sports, etc. But 
how many cases of menstruation are 
there that are absolutely normal, that 
are not accompanied with irritability, 
headaches, backaches and pain? Very, 
very few. The vast majority of cases 
have some symptoms or other, while of 
course in a certain percentage of dys- 
menorrheic cases, the periodic appear- 
ance of menstruation rises to the dignity 
of a real disease, and now and then a 
disease accompanied by torture. 
So much for menstruation troubles, 
troubles from which man is entirely 
free. 
Then take pregnancy, childbirth and 
lactation. Even at their best, these pro- 
cesses cannot be said to give the woman 
unalloyed joy. Even if we leave out the 
severe cases, the dangers, complications 
and accidents, pregnancy and childbirth 
carry with them troubles, worries and 
pains of which man is entirely free. 
And now coming to our special sub- 
ject, we have the menopause. While 
16 woman's heavier burden 
man also has some sort of change of 
life, it is so slight that the majority are 
hardly aware of it, and in those in which 
it is more definite, the troubles are prin- 
cipally of a psychic nature and transient 
in character. In women, however, the 
menopause is sometimes a very serious, 
a very troublesome event, now and then 
producing symptom complexes which 
cannot be disregarded. And for this 
reason the period of the menopause de- 
serves earnest study. 
It is possible that in the future, in an 
ideal state of society, in the eventual 
reality of which we cannot help believ- 
ing, woman will be properly compensated 
for the much more difficult part that she 
has to bear in the sexual domain. But 
at present we must in all fairness admit 
that the burdens are not equally divided, 
and that woman has a much heavier 
share to bear. 
17 CHAPTER II. 
MY FIRST CASE OF MENOPAUSE TROUBLE 
It was during the first year of my 
medical practice. A little old lady, 
whom I knew slightly, came to consult 
me. She was neat, trim and very slight. 
She could not have weighed more than 
a hundred pounds. She was somewhat 
hesitating in telling her trouble. She 
did finally manage to tell it. Here is 
what the trouble was. She was past 
fifty-five. She had had her change of 
life more than five years ago, and nev- 
ertheless, nevertheless . . . She still had 
"shameful" feelings. To translate it 
into our language, she still had strong 
erotic desires, in fact, she believed she 
was more passionate than she had been 
before the menopause. And she "knew," 
of course, that that was wrong, abnor- 
mal, and she wanted me to give her some- 
thing to stop it. 
Now, I have had a number of women, 
18 MY FIRST CASE 
old, middle-aged and young, who wanted 
me to give them some anaphrodisiac, 
something to quiet their sex urge which 
they had no normal way of allaying. 
But this was not the case with my little 
old lady. She did have a husband who 
could and did satisfy her quite well. 
But, simply, she entertained the then 
and even now still current idea that to 
experience strong sexual desire after the 
menopause was not only morally wrong, 
but was indicative of some physical ab- 
normality which needed treatment. And 
she wanted treatment. And I gave her 
treatment. I gave her bromides. Gave 
them liberally. The bromides allayed 
her libidio but little, but they upset her 
stomach and pimpled her face quite a 
good deal. But as she thought that that 
was as it should be, she raised no ob- 
jections. 
That shows how much I knew of sex- 
ology the first year after graduation. 
That's as much as all the other graduates 
knew. In fact, they knew still less, if 
that was possible. Because I at least 
19 MY FIRST CASE 
had read some sex books-even before I 
entered medical college; they had not 
read any; I doubt if they knew of the 
existence of books dealing specifically 
with sex problems; nothing except per- 
haps collections of smutty stories, and 
smuttiness is not sexology. No, not a 
single solitary word did the professors 
utter on the subject of sexology when I 
went to college, and they don't handle 
the subject now. Not sexology proper. 
Things however are not so bad now. 
For after coming out from college, many 
physicians are beginning to show a ser- 
ious interest in sexologic questions. Per- 
haps the present writer had something 
to do with that. And the laity is becom- 
ing more interested in sex, and they are 
more inquisitive as well as more articu- 
late. But of course the percentage of 
those truly enlightened in sex matters is 
still deplorably small, and the misinfor- 
mation, passing for truth, regarding the 
menopause would fill a fair sized vol- 
ume. It shall be the object of this vol- 
ume to dissipate the numerous and in- 
20 MY FIRST CASE 
jurious errors concerning the change of 
life in woman which still pass current. 
These errors are not only abstractly 
wrong, but they exert practically a very 
pernicious effect on woman's body and 
psyche. And I shall deal with the pre- 
vention of the dangers and disorders of 
the menopause, and with their treat- 
ment, from a practicing physician's 
point of view. 
21 CHAPTER III 
THE menopause: the meaning of the 
TERM-THE AGE AT WHICH 
IT OCCURS 
What is the menopause? The word 
menopause is derived from two Greek 
words: men-month, and pausis-ces- 
sation. It means the permanent ces- 
sation of the menses or the monthly 
periods. The menopause is also referred 
to as the climacteric or climacterium, 
from the word climax, which means a 
critical period or point of highest in- 
tensity. The most common popular term 
is "change of life." The year or two 
during which the menstrual periods are 
irregular, in other words, the period be- 
tween the commencement and the com- 
plete establishment of the menopause, is 
often referred to, particularly in Eng- 
land, as the "dodging period" or the 
"dodging years." 
22 AGE OF THE MENOPAUSE 
The term menopause is used in two 
senses. It is applied to the complete 
cessation of the menses, and is also used 
to designate the entire period of change 
of life, which may last one, two, or three 
years, or more. 
At what age does the menopause make 
its appearance? Taking a large num- 
ber of cases, we find that the most com- 
mon average age at which the monthly 
function ceases is between 47 and 48. 
Forty-three to forty-four used to be the 
age accepted, but whether that was due 
to wrong observation, or whether the 
menopause really comes on at a later age 
now than it used to formerly, the fact 
is that we meet with a great many more 
women who have their menopause at the 
age of forty-eight than at the age of 
forty-three or forty-four. This applies 
to the white races living in temperate 
climates. Race, climate, mode of living, 
etc., do make some difference in the 
time of the appearance of the meno- 
pause, as they do in the time of the ap- 
pearance of puberty. But generally 
23 AGE OF THE MENOPAUSE 
speaking, we can say that forty-eight 
years is the most common time. 
Healthy women who lead a normal 
sexual life and who have borne children 
generally have the menopause later than 
women who have had no sexual life at 
all, or who never bore any children. On 
the other hand, very frequent pregnan- 
cies often bring about a premature men- 
opause. 
The fact is also pretty well established 
that those who begin to menstruate early 
are apt to continue to menstruate late. 
A girl who begins to menstruate at el- 
even, twelve or thirteen, is apt to men- 
struate to the age of fifty or fifty-two. 
Those who begin to menstruate at fif- 
teen, sixteen or seventeen, are apt to get 
the menopause at the age of forty to 
forty-two. 
As stated before, the most common age 
is between forty-seven and forty-eight, 
but of course there are wide variations. 
Some women begin to have their meno- 
pause at the age of forty; some even 
earlier than that, while others keep on 
24 AGE OF THE MENOPAUSE 
menstruating with perfect regularity to 
the ages of fifty-three, fifty-four, fifty- 
five, fifty-six and fifty-seven, or even 
later. The earliest case of menopause 
in my own practice was thirty-two, 
while the latest was fifty-seven. There 
is no question that there are perfectly 
authenticated cases of menstruation up 
to the age of sixty. But cases of men- 
struation at the age of sixty-five or sev- 
enty are hardly authentic; most likely 
those are cases that had polypoid growths 
or tumors and the occasional or frequent 
bleeding from those was mistaken for 
menstruation. There are also cases on 
record of girls or women who began to 
menstruate at the age of eighteen or 
twenty, menstruated a few times, and 
then ceased suddenly and completely. 
But those cases belong among the ab- 
normalities. Any case of the menopause 
between forty and fifty-five-or to make 
the limits a little wider still-between 
thirty-eight and fifty-eight, belongs to 
the domain of the normal. 
25 CHAPTER IV. 
SYMPTOMS OF THE MENOPAUSE 
I wish I could say with bold assur- 
ance: "Forget it. There is no such thing 
as symptoms of the menopause; it is all 
imaginary, all a matter of the mind. It 
is your false beliefs and your fears that 
create the symptoms. If you make up 
your mind that the menopause is a per- 
fectly normal physiological period, you 
will have no symptoms." 
I wish I could do that. And what's 
more, such a statement, made with 
aplomb and without equivocation, would 
do some good. For knowing as we do 
that fear is in some cases the cause of 
symptoms, or at least, that it has an in- 
fluence in exaggerating certain symp- 
toms, such a reassuring statement would 
prove beneficial in a number of cases. 
But, alas, I cannot do it; because it is 
not true. 
While I admit that the dangers and 
26 SYMPTOMS OF THE MENOPAUSE 
disorders of the menopause have been 
exaggerated by the laity, and even by 
some medical writers, it is none the less 
true that the menopause does cause symp- 
toms in many perfectly healthy, perfect- 
ly normal women, women who are not 
given to imaginary maladies, to hyster- 
ical outbursts, and who are rather in- 
clined to hide and to minimize their 
troubles. And it is perfectly simple to 
understand why the menopause should 
cause symptoms. 
We know now the tremendous im- 
portance of the ductless or endocrine 
glands in the human economy. A nor- 
mal functioning of the ductless glands 
is absolutely necessary for a normal 
functioning of the organs of the body 
and of the mind. When we have ex- 
cessive functioning or hyper-function; 
diminished functioning or hypo-func- 
tion; or perverted functioning or dys- 
function, there is trouble. The least dis- 
turbance of the thyroid gland, whether 
it be hyer-function, hypo-function or dys- 
function, causes great trouble. While 
27 SYMPTOMS OF THE MENOPAUSE 
the ovary is not equal in importance to 
the thyroid, it is yet easy to under- 
stand why a disturbance in its function 
should cause symptoms. Especially so, 
when we bear in mind that a disturbance 
in one gland is apt to cause disturbance 
in all other glands, and a disturbance in 
the ovaries is very apt to cause disturb- 
ance in the thyroid. Now, there is no 
question whatever that during the meno- 
pause the ovaries undergo atrophy.' 
They shrink and shrivel, become the 
size of an almond, until finally in old 
age they become converted into nothing 
but a fibrous band. 
We thus see that the symptoms are not 
purely psychic in origin, that there is a 
real anatomical, organic cause for cer- 
tain symptoms of the menopause. 
28 CHAPTER V. 
WHAT ARE THE ORDINARY SYMPTOMS OF 
THE MENOPAUSE/' 
Let us first consider those symptoms 
with which we meet must frequently. 
Flushes. The practically classic symp- 
tom of the menopause, the symptom of 
which every woman speaks, is the flush- 
es of the face or body and the flashes of 
heat. All at once, either while talking, 
or standing, or walking, or even while 
sleeping, the woman will get a sudden 
flush. She feels her face, or a part of 
the body or the entire body, becoming 
hot and red. After a little while she 
breaks out in local or general perspira- 
tion, and a feeling of chilliness may suc- 
ceed the flushes or perspiration. In some 
women the flushes and the perspiration 
are so severe that they complain that it 
feels as if a pail of hot water had been 
poured over them. The flushes may be 
very fugitive, lasting only a few seconds; 
or they may last for several minutes or 
29 THE ORDINARY SYMPTOMS 
half an hour. They may occur once in 
several days, or they may occur a dozen 
times a day, and they may occur a dozen 
times an hour. They may vary in fre- 
quency and intensity from a slight an- 
noyance to a real torment. 
In some cases, there is an outbreak 
like urticaria (nettle-rash), and the 
skin remains red and elevated for a con- 
siderable period. 
The knowledge that the redness and 
perspiration are noticed by others ag- 
gravates the condition still further, and 
forces many women to seek seclusion. 
Irregularity in the Menstrual Periods. 
A change in the menses may be one of 
the first symptoms of the menopause. 
That is, a certain irregularity either in 
the intervals of the menses, in the dur- 
ation, or in the quantity or quality of 
blood lost. In some women these chang- 
es are very slight; simply a period or two 
are skipped, and the complete menopause 
is established. In some cases these 
"dodging" periods last for many, many 
months, or even years. And these ir- 
30 THE ORDINARY SYMPTOMS 
regular periods, either scanty or very 
profuse, may be accompanied with con- 
siderable pain and distress. 
Menorrhagia and Metrorrhagia. As 
just mentioned, in some cases the menses 
may be very profuse, so profuse that the 
term menorrhagia may be applied to 
them. 
In other cases, however, the uterine 
hemorrhage has no relation to any per- 
iodicity, may occur any time, be very 
profuse, then disappear for months and 
come on again. 
In every case of menorrhagia and met- 
rorrhagia, the patient should be prop- 
erly examined to make sure that there 
is not some pathologic basis for the hem- 
orrhages, such as fibroids, polypoid 
growths or even cancer. 
Irritability. The next most common 
symptom is a general "upsetness" and 
irritability. The woman is much more 
excitable, irritable, angry, quarrelsome, 
cries readily, worries over trifles, and 
now and then gets into hysterical tan- 
trums. 
31 THE ORDINARY SYMPTOMS 
Depression. A mild degree of depres- 
sion is very common in women under- 
going the menopause. Under the cir- 
cumstances, that is with a knowledge, 
or rather with the exaggerated ideas of 
the end of the sexual life, a mild degree 
of depression may be considered normal; 
but sometimes the depression becomes a 
genuine melancholia which needs very 
careful, sympathetic treatment. 
Indigestion. Digestive disturbances 
are very frequent during the menopause. 
One of the most annoying symptoms is 
flatulence. The whole abdomen becomes 
bloated, and there may be frequent and 
loud rumbling in the intestines. 
Constipation. Constipation is another 
annoying symptom. Where the woman 
suffered with constipation before the 
menopause, the constipation may become 
much aggravated. 
The Libido. The sexual desire may 
become altogether dead or diminished 
or very much exaggerated. As to the 
causes of the exaggerated libido, see 
Chapter on Increased Sexual Libido 
32 THE ORDINARY SYMPTOMS 
During and After the Menopause. 
Obesity. This is a not frequent 
symptom of the menopause. In some 
cases it is mild, merely helping to round 
out the figure; in other cases it becomes 
extreme, so that the patient becomes un- 
comfortable. 
The notion is prevalent that obesity is 
the cause of an early menopause. This 
has not been definitely established, tho 
there may be some grounds for the be- 
lief. It is very likely that in many cases 
both the obesity and the early meno- 
pause are the result of hypo-function of 
the pituitary; in other words, that we 
have to deal with dystrophia adiposo- 
genitalis, or Froehlich's syndrome. 
Among the other numerous symptoms 
of which women who pass thru the men- 
opause may complain, are the following: 
Vertigo. This is generally mild, but 
in some cases may be so severe that the 
patient falls unless she succeeds in catch- 
ing hold of something; fainting spells, 
palpitation of the heart. The tachycar- 
dia may be very severe, the pulse going 
33 THE ORDINARY SYMPTOMS 
up as high as 160 per minute. 
Nose Bleed. This symptom is rare, 
but does occur. The older physicians 
took it for vicarious menstruation. 
Headache. This is sometimes ter- 
rific. They complain that they feel as 
if the head would split, or as if the 
weight of a mountain were on it. They 
cry in destress, and hide themselves 
away in dark rooms. Only large doses 
of the various antipyretics seem to do 
any good. The headaches are sometimes 
periodic and sometimes accompanied by 
nausea and vomiting. 
Numbness and tingling. This is a fre- 
quent symptom, complained of particu- 
larly in the middle of the night. They 
will awaken and complain that their 
hands and arms or legs feel numb and 
paralyzed. They may be unable to 
move their limbs for some time, but that 
symptom usually disappears on massag- 
ing, or friction with a counter-irritant 
ointment. 
Pruritus. Itching is a frequent symp- 
tom, Sometimes the itching is limited 
34 THE ORDINARY SYMPTOMS 
to the genitalia, sometimes it is general- 
ized over the entire body. 
Irritability of the Bladder. This is a 
common symptom, particularly where 
there is pruritus of the vulva and va- 
gina. The patients sometimes have to 
urinate every fifteen minutes or half 
hour. 
Dermatoses. Skin diseases-particu- 
larly urticaria, are apt to be more fre- 
quent than at other periods. 
Some of the symptoms mentioned 
above will be discussed in more detail 
under separate chapters. Others will be 
referred to in the various histories of the 
cases of menopause patients. 
35 CHAPTER VI. 
THE PROPER ATTITUDE 
A great deal of harmful nonsense has 
been spoken and written about the dan- 
gers and diseases of the menopause. But, 
though not denying the reality of the 
menopause troubles, we must maintain 
that many of the dangers and diseases 
of the menopause are of our own making. 
Fear is a demon of most pernicious and 
most potent malignancy. It creates the 
things which it is feared it may create. 
Bring up a woman in the belief that 
the menopause is a most dangerous per- 
iod, full of pitfalls and dangers, replete 
with unavoidable physical and mental 
disorders, and she enters that period 
with fear and trembling; and minor 
symptoms which at other periods of her 
life she would disregard and perhaps 
pay no attention to, are taken to be the 
premonitory and corroborative signs of 
serious and expected illnesses. And 
36 Pages 37-52 missing SURGICAL MENOPAUSE 
severe as to produce a horror of the act. 
If the operation is successful in the true 
sense of the word, if all pathologic and 
inflammatory products are removed and 
the woman makes a good recovery, so 
that the act no longer causes any pain, 
it is natural that she should enjoy the 
act more than before. 
Then there comes in the other point, 
which I referred to in discussing the li- 
bido and the general menopause, namely, 
the freedom from the fear of pregnancy. 
Taking all these factors into consid- 
eration, it is not difficult to understand 
why in some women sexual enjoyment 
should be greater after a surgical meno- 
pause than before. 
These facts, however, also make us 
face the problem, if some other organ 
besides the ovaries is not concerned in 
maintaining the libido. Quite likely 
there is a brain center controlling the li- 
bido; the impression made on the brain 
center may continue indefinitely after 
the ovaries have been removed or have 
become atrophied. 
53 CHAPTER XII. 
THE HUSBAND AND THE MENOPAUSE 
There is one important cause of a wo- 
man's menopause troubles which is sel- 
dom referred to, but which, if you wish 
to speak with perfect frankness, is one 
of the most important factors in the dis- 
orders of the menopause, particularly 
those of a psychic character. That fac- 
tor is-the Husband. I would be within 
the limits of truth if I stated that in 
many cases, woman's psychic troubles 
during the menopause are due exclu- 
sively to the husband. I am not pro- 
nouncing any moral judgments. I am 
merely stating facts as they are. 
And these are the facts. It so usually 
happens that while the woman is under- 
going her menopause, the man is also 
undergoing a sort of change of life. The 
male climacteric, though not so pro- 
nounced and not with such distinct lines 
of demarcation as woman's, is neverthe- 
54 HUSBAND AND MENOPAUSE 
less a well-established fact. Just as a 
woman becomes irritable and cranky 
during the menopause, the man is also 
apt to become irritable and cranky dur- 
ing his climacteric. The mutual irrita- 
bility leads to squabbles and quarrels, 
and a vicious circle is established, which 
keeps on making matters worse. 
A man's libido is apt to be very erratic 
during his climacteric. If his libido is 
increased, if he is in a continual state of 
eroticism, which eroticism may be caused 
by local conditions, such as an irritable 
prostate, or due to constitutional causes, 
namely a hyper-functioning of the go- 
nads, he may begin to run after other wo- 
men, or what is still worse, may become 
infatuated or fall in love with a young 
woman. The wife is thus neglected, and 
both the neglect and the jealousy cause 
in her a severe psychic upset; lack of 
emotional satisfaction may cause intense 
depression, and the lack of physical sa- 
tisfaction may, and often does, create a 
greatly increased libido. The increased 
libido finding no satisfaction, increases 
55 HUSBAND AND MENOPAUSE 
the general irritability and nervous in- 
stability, and thus we have another vi- 
cious circle established, the nervous 
condition reacting upon the physical 
and the physical upon the nervous. 
Of course, some husbands are mean 
and cruel; having lost all love or physi- 
cal desire for the wife, they think they 
owe her no duty. This belief of theirs is 
approved by the moral code of some of 
our ultra-radicals, and it bothers them 
very little what mental and physical 
tortures the wife undergoes. 
But the husband need not necessarily 
be mean. He may be the kindest and 
gentlest of men, and he may try to do 
everything for his wife that is in his 
power to do, and yet his libido may be 
stronger than his reason and his sense 
of duty. He may try to conceal his in- 
difference or aversion, but the wife, un- 
less she is particularly obtuse-and it is 
her good luck if she is-can generally 
see through. And while his attempts to 
act kindly, to prevent and to heal the 
hurt, may soften the blow, a blow it is, 
56 HUSBAND AND MENOPAUSE 
nevertheless, and she feels it. 
Of course, for jealousy to cause intense 
suffering, it is not necessary for the wife 
to love her husband. Some wives may 
be utterly indifferent to their husbands, 
or even hate them, but as soon as a cause 
for jealousy is given, be the suspicion 
well-founded or groundless, they become 
intensely jealous. It should be men- 
tioned, however, that there are wives 
who are quite indifferent to their hus- 
bands going about with other women. 
They really do not seem to care the least 
bit about it, and some are even glad- 
"Let him do as he pleases as long as he 
leaves me alone." 
I stated before that man's libido dur- 
ing his change of life between forty-five 
and fifty-five is apt to be increased, and 
this may drive him to extra-marital af- 
fairs. But the libido may also be greatly 
diminished or entirely extinguished, and 
this is another cause for trouble. If the 
husband on account of his diminished 
libido, gives up having relations with 
his wife, she suspects him of infidelity, 
57 HUSBAND AND MENOPAUSE 
she thinks he gave her up because of 
other women, and this leads to trouble 
and mental suffering. But if she does 
not suspect him, if she knows that he is 
true and faithful, there is physical suf- 
fering on account of lack of sexual satis- 
faction. Physical suffering is never so 
great as mental suffering, but it is suffer- 
ing nevertheless, particularly so if the 
wife's libido unfortunately happens to 
remain undiminished or has even become 
intensified. 
We see in how many ways the husband 
may become the witting or unwitting, 
the deliberate or helpless cause of the 
wife's physical and mental suffering. 
Fortunately it is not always so. Many 
husbands and wives go along on Life's 
pathway pari passu. In both there may 
be an almost synchronous intensification 
of the libido; in both the libido may 
gradually diminish and become extin- 
guished. Both may bloom up during 
the change of life; and both may grow 
old gracefully at the same time. Those 
are the fortunate couples; the envy of 
58 HUSBAND AND MENOPAUSE 
the gods. And I believe I can do no 
better than to end this paragraph with 
the words with which I concluded the 
brief chapter on the menopause in Wo- 
man: Her Sex and Love Life. 
"Just as a man should be particularly 
kind and considerate to his wife during 
her menopause, so the wife, understand- 
ing that her husband is going through 
a critical period, will also increase her 
tact, patience and consideration." 
59 CHAPTER XIII 
THE M ENOPAUSE AND IMAGINARY 
PREGNANCY 
A peculiar symptom that sometimes 
makes its appearance during the meno- 
pause is that of imaginary or false preg- 
nancy, also called spurious or phantom 
pregnancy. 
The victims of imaginary pregnancy 
are very seldom married women who 
have had several children; they are gen- 
erally women who have been married a 
number of years without having given 
birth to a child, or old maids who may 
have indulged in sexual relations occa- 
sionally, or who may never have had any 
intercourse at all. 
The woman suddenly becomes con- 
vinced that she is pregnant. There are 
certain symptoms which support her in 
her belief. Thus many women as we 
know become obese during the meno- 
pause and there may be a large deposit 
60 IMAGENARY PREGNANCY 
of fat on the abdomen which simulates 
an actual enlargement of the womb. 
Also the gas in the bowels with which 
so many women suffer during the meno- 
pause enlarges the abdomen and by its 
movements in the intestines may simu- 
late fetal movements. The intense de- 
sire of the woman to be pregnant, and 
the physical symptoms which simulate 
pregnancy, convince her thoroughly that 
she is pregnant, and the doctor has a 
hard task to convince her of the con- 
trary. 
This imaginary, or phantom preg- 
nancy, may ''happen" to women who 
have been several years over their meno- 
pause. But the extreme limit are those 
poor old maids who never had any sex 
relations whatever, and still imagine 
that they are pregnant. Psychoanalysts 
understand the origin of this delusion. 
Of course, sometimes this imaginary 
pregnancy is one of the symptoms of 
oncoming or established insanity. 
61 CHAPTER XIV. 
CANCER AND THE MENOPAUSE 
One of the meanest and cruellest 
things is the belief inculcated in some 
women that the menopause causes can- 
cer., It is a cruel falsehood. The meno- 
pause by itself is never the cause of can- 
cer. It is true that cancer is more often 
found in women during the menopause 
than before the menopause, but that is 
simply because cancer is a disease of old 
age, and we always find much more can- 
cer at the age of 50 than at the age of 
30. And so it is with women-the two, 
the menopause and the cancer, are coin- 
cident, but the latter is not the result of 
the former. 
Whenever there is pain, discharge and 
irregular uterine hemorrhage, whether 
before, during or after the menopause, the 
woman should be thoroughly examined. 
If the generative organs-the uterus or 
the cervix-present the least suspicious 
62 CANCER AND MENOPAUSE 
appearance, a scraping should be made 
for the purpose of examination; and 
if the suspicion of cancer is justified, 
an immediate operation should be per- 
formed. Cancer of the womb is one of 
the things that brook no delay. Every 
month, every day of useless tarrying ren- 
ders the condition more serious and less 
operative. I am no alarmist and am not 
in favor of hurried operations, but in 
cancer, no matter where, the sooner the 
thing is removed, the better. It is a 
nasty, treacherous, and so far, still baf- 
fling disease. 
In certain cases good results can be ob- 
tained by the cautery, by the X-ray or 
radium; but this is for the specialist to 
decide. 
The exact nature of cancer is still un- 
known. It is known, however, that con- 
tinuous, prolonged irritation may be one 
of the causes of cancer. It is not sur- 
prising that a torn, lacerated cervix, 
constantly bathed in acrid secretions 
should eventually develop a malignant 
neoplasm. I therefore repeat again and 
63 CANCER AND MENOPAUSE 
again, that erosions of the cervix should 
not be neglected, and leucorrhea should 
not be permitted to go on for years and 
years without treatment. I am con- 
vinced that if the female genitalia were 
always in a condition of scrupulous 
cleanliness, that many of the so-called 
"female diseases" and the local disorders 
of the menopause would be much rarer 
then they are now. 
CANCER OF THE BREAST 
Not every lump in the breast means 
cancer. Many swellings and tumors of 
the breast are perfectly harmless or be- 
nign in their nature. But we must have 
certainty. And it's better to be sure than 
to be sorry, better to go to a competent 
surgeon and make sure that everything 
is all right than to delay going until it 
is too late. 
Of course, cancer is more common in 
women during or after the menopause 
than before, but here again, it is not the 
menopause that is the cause of the can- 
cer. It is age that is the cause of both. 
64 CHAPTER XV. 
TREATMENT OF SOME OF THE MENOPAUSE 
SYMPTOMS 
The Treatment of the Menopause 
Flushes.-A number of glandular prep- 
arations, particularly corpus luteum, 
ovarian residue and thyroid, have been 
given for this condition with varying 
degrees of success and failure. I have 
found none better, none more efficient 
than atropine sulphate, in doses of 1/120 
-1/100 of a grain. In severe cases, 
where it is necessary to make a strong 
physiological impression on the patient, 
one or two doses of 1/60 grain may be 
given. No dogmatic statements of the 
value or worthlessness of valerian in its 
various preparations can be made, but 
the modern valerian preparations, such 
as brovalol may be given, and seem to 
possess more than a suggestive value; 
the same is true of bromural. 
Of course, it goes without saying 
65 TREATMENT OF SYMPTOMS 
that general hygienic measures must not 
be neglected. Sharp spices, alcohol in 
all forms, strong coffee or tea must be 
eliminated. Warm baths are useful and 
may be taken daily. But the bath must 
be pleasantly warm, neither too hot nor 
too cold. 
Sponging the body with aromatic vin- 
egar (acetum aromaticum) is useful. 
Treatment of Fainting (Swooning). 
First, don't lose your own head. Then 
lower the patient's head-put her on a 
bed, couch or floor, loosen all constrict- 
ing articles of clothing, corsets, garters, 
etc., and admit plenty of fresh air. 
Sprinkling cold water on the face, or in 
severe cases, even slapping with a wet 
towel is perfectly all right. Putting 
strong smelling salts or a little am- 
monia water to the nose is often alone 
sufficient to bring the patient to. When 
the patient has regained consciousness 
and is able to swallow, a few drops of 
aromatic spirit of ammonia or Hoff- 
mann's anodyne will prove useful. 
Nosebleed. Nosebleed during the 
66 TREATMENT OF SYMPTOMS 
menopause is not a very frequent symp- 
tom, but must be treated when it occurs. 
Proceed as follows: Raise both arms 
above the head and keep them so for a 
few minutes; this alone will suffice to 
stop nosebleed in many cases. Passing 
a piece of ice along the nape of the neck 
or along the bridge of the nose is often 
effective. If the nosebleed is more ser- 
ious, pack the nostril from which 
the blood comes with absorbent cotton 
dipped in pure peroxide of hydrogen, or 
if the bleeding is very obstinate, in a ten 
per cent solution of antipyrin. Do not 
remove the cotton too soon. 
A piece of ice or a cold compress over 
the nose while it is packed with cotton 
is an additional good measure. 
67 CHAPTER XVI. 
THE MENOPAUSE AND INSOMNIA 
Insomnia is a very frequent and very 
annoying symptom of the menopause. 
Its management, however, is not mater- 
ially different from the management of 
insomnia at any other period. 
First of all, the woman must be con- 
vinced that insomnia is not quite so in- 
jurious as it is generally believed to be. 
For, as I have emphasized so many times 
before, the fear of harm sometimes causes 
more harm than the actual harm itself. 
The woman must be urged to be calm, 
and not to fret and fidget even when 
she cannot sleep. If she likes reading it 
would be well for her, instead of tossing 
about, to get a light and read for an hour 
or two. This is number one. 
Second, we must utilize all hygienic 
measures at our command to induce 
sleep. A warm bath before going to bed 
is decidedly useful. Just lukewarm, not 
68 INSOMNIA IN MENOPAUSE 
hot. If there is a tendency to cold feet, 
a hot water bottle is useful. Not only 
in the winter, but also in the spring and 
fall, and even in the summer. -The nights 
sometimes get cold and the feet may get 
chilled. A few crackers and a glass of 
hot milk before going to bed, or a large 
glass of malted milk, sometimes prove 
beneficial and induce sleep. A general 
massage before going to bed often acts 
well. 
Where these measures, after having 
been given a judicious trial, fail, we 
must have recourse to drugs. I have 
not that foolish superstitious fear of 
drugs that some quasi-physicians have. 
Used when indicated and in the proper 
doses, and stopped when the need for 
them has passed, they prove not only 
beneficial, but now and then even life- 
saving. It is best to start with mild hyp- 
notics, and to change off. Adalin in io 
grain doses is very good. Or a combina- 
tion of adalin, 5 grains, and luminal %- 
grain may be given. If adalin is too 
mild to induce sleep, veronal should be 
69 INSOMNIA IN MENOPAUSE 
given a trial. In doses of 7% to 10 grains 
in a cup of hot water or hot milk, it 
seldom fails to induce a good sound 
sleep. 
Hypnotics should be taken under 
physician's directions only; they should 
not be obtainable except on a physician's 
prescription; when used under a wise 
physician's directions they cannot do 
any harm. Occasional doses of chloral 
or sulphonal or trional may be given in- 
stead of veronal or adalin. Morphine 
should not be given except on very, very 
rare occasions, where we have to deal 
with a case of extremely recalcitrant in- 
somnia. But I wish to emphasize that, 
if after trying suggestion, dietetic and 
hygienic measures sleep fails to come, 
we should not be afraid to use drugs in 
efficient doses. The habit of sleepless- 
ness must be broken. Drugs may be an 
evil, but they are often a lesser evil than 
insomnia. 
Where the insomnia is due to an un- 
gratified libido, the remedy is obvious. 
Where the remedy cannot be employed, 
70 INSOMNIA IN MENOPAUSE 
we simply have to do the best we can. 
What cannot be cured must be endured. 
But with commonsense and with the aid 
of diet and hygiene, and the occasional 
use of drugs, we can make the enduring 
more endurable. 
Another point. We should first make 
sure that the woman is actually suffer- 
ing from insomnia. Not every patient 
who complains of insomnia has insom- 
nia. Leaving aside the cases of hysteria, 
where the woman complains of insomnia 
to excite sympathy, there are cases where 
the woman sleeps lightly, sleeps through- 
out the night, and still is convinced that 
she did not sleep. People would come 
into the room, she would not hear, and 
yet she would afterwards assert that she 
was awake all the time. She is sincere 
and acts in good faith, but the fact is- 
she is not a victim of insomnia. 
71 CHAPTER XVII 
TREATMENT OF THE INCREASED LIBIDO 
DURING THE MENOPAUSE 
If the menopause patient who is af- 
flicted-for it is an affliction-with an 
increased libido is an unmarried woman 
or a widow, then the question is not one 
for the physician to answer. It becomes 
a moral or a social question which each 
woman has to answer for herself. But 
if the patient is a married woman, then 
two points are to be considered. Is the 
libido genuine, spontaneous, and only 
somewhat exaggerated, or is it rather a 
spurious libido, a libido of irritation, 
and is it so enormously exaggerated that 
it may be considered abnormal, patho- 
logical? 
With a frank heart-to-heart talk the 
question can be answered. If the wo- 
man has a sense of well-being after coitus, 
and if she becomes serene and satisfied 
for several days, then the libido may be 
72 TREATMENT OF INCREASED LIBIDO 
considered of a normal character, even 
if somewhat intensified. If, however, 
there is little satisfaction, little euphoria 
or sense of well-being, and if she has a 
continual hankering after coitus, or 
what is still worse, if after coitus there is 
an increased desire for the act to be re- 
peated, then the libido is to be considered 
abnormal, pathological, or due to local 
causes. 
In the first case, that is, when the li- 
bido is normal, the remedy is obvious. 
But even here a word of caution is ne- 
cessary. For it is unfortunately true 
that very often, and particularly so dur- 
ing the menopause, coitus is a flame that 
feeds upon what it consumes. When the 
libido is strong, and it needn't be very 
intensely so, coitus instead of quenching 
the flame often fans it. And I there- 
fore say and repeat what I said once be- 
fore, that women during the menopause 
should not indulge in frequent sex rela- 
tions. They are apt to injure themselves 
locally by causing congestion of the gen- 
erative parts, they are apt to injure 
73 TREATMENT OF INCREASED LIBIDO 
themselves constitutionally, they are apt 
to increase instead of diminishing their 
libido. 
When we come to the case of an ab- 
normal, strongly exaggerated libido, 
then sexual relations must be unequivo- 
cally forbidden. Because they may lead 
to greatly increased and unquenchable 
eroticism-may perhaps lead to nympho- 
mania. In such cases, sedatives, such as 
adalin or luminal, five grains of the for- 
mer and one-quarter grain of the latter, 
or even the bromides in large doses (30 
to 60 grains of the combined bromides) 
may be given. A thorough local exam- 
ination should be made, for it is well 
known that increased libido may be 
caused by an inflamed cervix, vagina or 
vulva. Where the cervix is found to be 
pathological, it should, of course, be 
treated until a normal condition it 
brought about. Where the cervix is 
eroded, it should be touched with appli- 
cations of tincture of iodine, silver ni- 
trate or zinc chloride. Where it is swol- 
len and congested without being eroded, 
74 TREATMENT OF INCREASED LIBIDO 
it may be scarified so that two or three 
ounces of blood may be withdrawn. 
Glycerin tampons, or tampons of gly- 
cerin with 5 per cent, of boric acid, or 
2 per cent, of ichthyol, are decidedly 
useful in relieving uterine and vaginal 
congestion. 
No ironclad rules, but commonsense 
and sane, unbiased judgment will help us 
to deal adequately with the largest per- 
centage of cases of increased libido dur- 
ing the menopause. 
75 CHAPTER XVIII 
THE TREATMENT OF OBESITY 
Obesity is a frequent occurrence dur- 
ing the menopause and the treatment of 
this condition which I outlined in "Mar- 
ried Life and Happiness," will be effi- 
cable here. Ldi t 
The first requirement in treating ob- 
esity is, of course, reduction in the 
amount of food, but particularly must 
we reduce the starchy foods. As little 
bread as possible, and that only toasted 
or Graham bread. No potatoes under 
any circumstances, no pies, pastry or 
puddings, and of course no fats, either 
butter, lard or any other kind of fat. 
No sugar. Sugar is the worst-or the 
best-of fatteners. One can get used to 
drinking tea and coffee without sugar. 
In fact, the Japanese and the Chinese 
never use sugar in their tea-all Orien- 
tals claim that sugar spoils the taste of 
these two beverages. But those who 
76 TREATMENT OF OBESITY 
cannot get used to unsweetened tea or 
coffee can use saccharin instead of sugar. 
One or two tablets are equivalent to one 
or two lumps of sugar and one hardly 
knows the difference. 
Meat may be eaten in plenty, but only 
lean meat. All fat must be cut away. 
The white of chicken is permissible. 
No salt. This is an important point. 
In any successful treatment of obesity, 
salt should be entirely eliminated. 
Plenty of fruit. All fruit may be 
eaten in abundance with the exception 
of bananas. 
No nuts because nuts are very fat- 
tening. 
If the patient has a feeling of empti- 
ness in her stomach, she can fill herself 
up with substances of little nutritional 
value, but which remove that feeling of 
hunger. Such substances are cabbage 
and salads of all kinds. Of course, such 
salads should be eaten without any salt 
or oil, only with a little vinegar. 
Baths should be taken daily. A warm 
bath followed by a cold shower or 
77 TREATMENT OF OBESITY 
sponge, and then the patient is to rub 
herself thoroughly dry with a rough 
Turkish towel. Very fat persons can 
use a masseuse, but the most useful form 
of massage is the kind of massage that 
the patient administers herself. 
Sea bathing is very useful, but the pa- 
tient must exert her will-power not to 
eat too much after the bathing. Sea 
bathing, as is well known, often increases 
the appetite enormously, and if the pa- 
tient should yield to her appetite, all the 
good derived by the sea bathing would 
be neutralized by the extra consumption 
of food. 
That walking is necessary goes with- 
out saying. If the patient is so fat that 
she puffs readily and gets short of 
breath, the walks should be short and 
frequently repeated, but gradually they 
should be lengthened until the patient 
walks several miles a day. Then she 
should exercise. One of the simplest 
forms of exercise is to lie down on the 
floor on a mattress and try to raise her- 
self to a sitting position without the aid 
78 TREATMENT OF OBESITY 
of the hands or arms. This strengthens 
the abdominal muscles and increases the 
circulation and helps to reduce the fat. 
Rolling a heavy ball on the abdomen 
and raising and lowering the legs is use- 
ful. Walking on all fours, though per- 
haps not very dignified, is a very useful 
method of exercise. 
In addition to this, the physician will 
prescribe small doses of thyroid. One 
must bear in mind that thyroid may be 
taken only when the patient has been 
examined and found to have a perfectly 
normal heart. 
Small doses of borax-8 grains three 
times a day-are claimed to be bene- 
ficial. 
In brief, the patient who is really an- 
xious to lose her excessive avoirdupois 
need not despair : with will-power and 
the doctor's help wonders can be ac- 
complished. 
79 CHAPTER XIX. 
TREATMENT OF CONSTIPATION 
Constipation during the menopause 
may be very obstinate, and must be 
treated and overcome. But I wish to 
repeat what I said elsewhere that a great 
deal more injury has been and is being 
done to the human system by the habi- 
tual taking of cathartics than by habitual 
constipation. 
Of course, constipation, and particu- 
larly constipation during the climacter- 
ium, should be treated. But before giv- 
ing medicines, everything should be 
done to overcome it by dietetic measures. 
The diet may have to be radically 
changed. It is possible that the per- 
son's food does not contain enough 
residue-the bowels must have some resi- 
due to work upon, to push forward be- 
fore they can move. In such cases, we 
should see that her food contains plenty 
of residue-she should eat coarse bread, 
bran, cabbage, plenty of raw fruit; in 
80 TREATMENT OF CONSTIPATION 
addition, she should eat things that are 
known to be laxative in character, such 
as prunes (raw), figs and apples. And 
she should avoid constipating articles, 
the most representative of which is 
cheese. Coffee, particularly in the 
strength in which it is usually drunk in 
this country, is also constipating, though 
it must be stated that on some people 
coffee has a laxative effect. But coffee 
is bad for another reason: for its effect 
on the flushes. 
If the change of diet alone does not 
have the desired effect, other measures 
must be tried in addition. Massage of 
the abdomen is sometimes helpful, 
though its results are not so wonderful 
as its advocates try to make us believe. 
Very often it is without any results 
whatever. Walking is often advised in 
constipation, and it sometimes does 
good. We know that a sedentary occu- 
pation is conducive to constipation, but 
on the other hand, there are plenty of 
people who are always on the go, and 
who are victims of very obstinate con- 
81 TREATMENT OF CONSTIPATION 
stipation. Walking may help in some 
cases, but it is certainly no panacea. 
If the proper diet, plus massage, plus 
walking have not accomplished the de- 
sired results, other measures must be em- 
ployed in addition. And the simplest 
is an enema or rectal injection. Inject 
from a douche bag (or glass or tin res- 
ervoir) or from a bulb syringe, one-half 
a pint to a pint of cool water and retain 
for a few minutes; where the constipa- 
tion has been severe and prolonged and 
the feces are hard, water alone may not 
suffice, and it may be necessary to add 
some soapsuds to the water, or to dis- 
solve in it some Epsom Salt-one or two 
tablespoonfuls of Epsom Salt to a pint 
of water. This will generally produce 
a very good evacuation. Injecting into 
the rectum 2 to 4 drams of glycerin gen- 
erally works quite well. The insertion 
into the rectum of a glycerin suppository 
is less troublesome than the pure gly- 
cerin, but is not so efficient. 
Liquid Petrolatum, or Mineral Oil or 
Russian Mineral Oil is used extensively. 
82 TREATMENT OF CONSTIPATION 
It is the least injurious of the internal 
laxatives, because it does not irritate the 
bowels, acting principally as a lubricant, 
but again it is not as wonderful a thing 
as its producers and sellers would make 
us believe. First, it does not cure con- 
stipation; it relieves it as long as it is 
taken, and that's all. And second, on 
some people, it doesn't act at all; it just 
passes out of the rectum in an unchanged 
condition, without producing any move- 
ment at all; it oozes out, soiling the linen, 
and is merely annoying to the patient 
without doing him any good. If the li- 
quid petrolatum does not act well, then 
for a change, the fluid extract of cascara 
sagrada, 15 to 30 drops at night or night 
and morning, is the least objectionable. 
Agar-agar does not act as a drug-it just 
absorbs water and increases the bulk of 
the feces-may be taken now and then, 
the feces-and may be taken now and 
then. There is an improved bran now 
on the market and it may be given a trial. 
83 CHAPTER XX. 
TREATMENT OF WIND AND RUMBLING IN 
THE BOWELS 
Most people have a little rumbling in 
the bowels now and then. (Borborygmi 
in medical language.) It is due to the 
movements of intestinal gas. But dur- 
ing the menopause some women suffer 
from this condition in an aggravated 
form. The rumbling is very frequent 
and is so loud that it can be heard at a 
distance. The condition can be readily 
cured, or at least improved. Have the 
following prescription made up: 
Oil of Turpentine (the purest kind) 
2 drams. 
Spirit of Peppermint, 5 drams. 
Spirit of Chloroform, 1 dram. 
Pour 20 or 30 drops on a lump of su- 
gar and take down. Repeat the dose 
four times a day. The drops may also 
be taken in a tablespoonful of water, but 
it tastes much more unpleasant. 
[84] TREATMENT OF WIND 
In severe cases I also advise the ap- 
plication to the stomach of a turpentine 
stupe, once or twice a week. Take a 
Turkish towel wrung out of boiling wa- 
ter, sprinkle over it about a tablespoon- 
ful of oil of turpentine and apply to ab- 
domen. The stupe burns considerably, 
but it does good. In some cases, it may 
also become necessary to wear a snug, 
well-fitting abdominal bandage. 
In very obstinate cases, in addition to 
the drops recommended above, the pa- 
tient may have to take the following 
powder: 
Pure Willow Charcoal, 4 ounces. 
Subnitrate of Bismuth, 1 ounce. 
One or two teaspoonfuls one hour af- 
ter meals. 
Do not take cathartics, except under 
a physician's direction; they weaken the 
bowels and make matters worse. In 
fact, many cases of gas, noise and rumb- 
ling in the bowels are due to the frequent 
taking of laxatives and cathartics. 
LSsl CHAPTER XXI. 
TREATMENT OF ITCHING OF THE VULVA. 
Itching of the vulva is one of the most 
frequent disorders of the menopause. 
It may vary in persistence and in intens- 
ity from a mild discomfort to one of the 
most terrible torments. It is sometimes 
so severe that the pitiful wail, "I will 
go crazy unless you do something to re- 
lieve me," seems to express the true 
state of affairs, and is not merely the 
exaggerated cry of an hysterical woman. 
The itching is so severe at times that 
sleep is completely banished. Some wo- 
men cannot close their eyes for a minute, 
and must indulge in the most violent 
scratching, even if the scratching afford 
but little relief. Even when they know 
that it is against the doctor's orders, and 
that the scratching will result in an ag- 
gravation of the condition, they cannot 
refrain from it. It is beyond their 
power. The scratching is so severe as 
to denude the skin and mucous mem- 
86 TREATMENT OF ITCHING 
brane and to cause considerable bleed- 
ing. This may give a temporary relief, 
but in a little while the itching may be 
more severe than ever. 
The itching may be limited to the 
vulva, but sometimes it extends into the 
vagina, and then the condition is much 
worse because scratching with the fin- 
gers does not suffice, and the unfortun- 
ate women are obliged to introduce for- 
eign objects into the vagina with which 
to perform scratching. This of course 
may result in considerable traumatism. 
The itching may also extend to the 
perineum and into the anus, which makes 
matters much worse. 
On examination, the vulva and other 
parts which are the seat of the itching, 
will be found congested, inflamed, or 
eczematous. These cases are the easiest 
to cure. In some cases, however, no lo- 
cal change of the part whatever can be 
noticed (except that produced by the 
scratching). The skin and the mucous 
membrane appear perfectly normal. 
These are the hardest cases to cure. For 
87 TREATMENT OF ITCHING 
such cases are of a nervous or neurotic 
origin, and pruritus or itching which is 
not due to local causes, but is of a so- 
called nervous origin, is often extremely 
difficult to cure. 
Cases of itching due to an irritating 
leucorrheal discharge are easily cured, 
because as a rule it is easy to cure, or at 
least to diminish and to relieve, the acrid- 
ity of a leucorrheal discharge. Of course 
where the itching is due to an irritating 
discharge from a cancerous cervix, the 
matter is different; but then it is the 
cancer that we have to treat. The itch- 
ing is of secondary importance, though 
it may cause more torment than the can- 
cerous condition itself. 
Where the itching is mild, mild treat- 
ment may suffice. Vaginal douching 
with a weak iodine solution, solution of 
resorcin or chinosol, is always advisable. 
Compresses of resorcin may be applied 
to the vulva, or an ointment of phenol, 
resorcin and zinc oxide, as per the fol- 
lowing formula: 
88 TREATMENT OF ITCHING 
Phenol, % dram. 
Resorcin, % dram. 
Zinc oxide, 2 drams. 
Petrolatum, 1 ounce. 
In more severe cases, swabbing and 
painting the entire vagina, cervix and 
vulva with undiluted tincture of iodine 
often does the work. It burns, but it is 
worth it. In still more severe cases, 
painting the vulva with pure (95%) 
phenol, followed immediately by a com- 
press of alcohol, will often prove effi- 
cient. 
Where the vaginal discharge is very 
acrid or acid, frequent douching with 
sodium bicarbonate solution is advisable. 
Or several sodium bicarbonate tablets 
may be inserted into the vagina. 
Ichthyol-glycerin tampons (10%) are 
decidedly beneficial in relieving con- 
gestion. 
As far as the perineum and anus are 
concerned, painting with a strong silver 
nitrate solution (10 to 20%), rubbing in 
with camphor menthol (equal parts of 
camphor and menthol) are of decided 
89 TREATMENT OF ITCHING 
benefit. If the itching is limited to the 
anal orifice, an ointment such as we men- 
tioned before may suffice. If the itching 
is deeper, then the use of suppositories 
becomes necessary. The following is a 
good formula: 
Resorcin, i grain. 
Ichthyol, 2 grains. 
Extract belladonna, % grain. 
Cocoa butter, 20 grains. 
For one suppository. 
There are also a number of ready- 
made suppositories, such as Anusol or 
Bismolan, which are quite efficient. 
That severe scratching and handling 
of the vulva and vagina may lead to and 
end in a masturbatory act is well known. 
But here is a point which is but little 
known and to which little attention has 
been paid, but which must be faced 
frankly; it is only by facing it frankly 
and speaking about it frankly to the 
patient, that we may obtain relief in cer- 
tain cases. 
The point is this. In certain cases, 
the pruritus or itching is not of the or- 
90 TREATMENT OF ITCHING 
dinary character, but is distinctly of a 
libidinous or sexual character. In fact, 
in some cases it isn't really itching that 
we have to deal with; it is the irritation, 
tingling and congestion caused by libi- 
dinous excitement which is mistaken for 
pruritus. In some cases, it is not even 
mistaken for pruritus; the woman knows 
the real character of the sensation, but as 
scratching relieves the sensation and af- 
fords a certain amount of erotic pleas- 
ure, she indulges in it. 
If the scratching is violent and causes 
certain abrasions, etc., these latter may 
become infected and give rise to lesions 
which are mistaken for dermatitis, ec- 
zema, etc. But we really have to deal 
here with libidinous tumescence and 
irritation and their relief by masturba- 
tory friction and scratching. That the 
libido may be greatly increased during 
the menopause is well known, and is dis- 
cussed in another part of this book. 
The victim of this variety of pruritus 
may be reluctant to accept and admit 
your explanation, but it is important, as 
91 TREATMENT OF ITCHING 
I said before, to face the facts frankly, 
because it is only by doing so that we 
may be able to render assistance. 
Of course it goes without saying that 
in every case of pruritus vulvae, the phys- 
ician must make sure that he has not a 
case of diabetes to deal with. It should 
not be necessary to mention this fact. 
Yet it is necessary because I did have a 
case of a woman with itching of the vulva 
who was given all kinds of lotions and 
ointments and stuffed with bromides in- 
ternally, without any relief. When she 
came to me, I found her urine loaded 
with sugar. 
Where the case is one of diabetes, the 
diabetes is, of course, primarily to be 
dealt with, though the local treatment is 
not to be neglected either. 
92 CHAPTER XXII 
ECZEMA OF THE VULVA 
Eczema is not a special disease of the 
menopause, though it is perhaps apt to 
be somewhat more common then, than 
at other periods. The skin is dryer and 
more vulnerable. And leucorrhea is 
more apt to cause eczema than at other 
times. 
The treatment consists in treating the 
leucorrhea and applying soothing pow- 
ders or ointments to the vulva. In mild 
cases, stearate of zinc will do. In other 
cases, an ointment of resorcin, zinc ox- 
ide, bismuth subnitrate, with or without 
oil of cade, will prove valuable. The 
following are good ointments: 
Salicylic Acid, io grains. 
Zinc Oxide, 2 drams. 
Starch, 2 drams. 
Petrolatum, 2 ounces. 
Apply thickly, cover with absorbent 
cotton or gauze. 
93 ECZEMA OF THE VULVA 
If the eczema has assumed a chronic 
character, use the following ointment: 
Resorcin, 15 grains. 
Zinc Oxide, 2 drams. 
Bismuth Subnitrate, 2 drams. 
Oil of Cade, 1 dram. 
Petrolatum, 1 ounce. 
Apply two or three times a day. 
In cases of very chronic eczema, with 
the skin rough and thickened, a stronger 
ointment should be used: 
Salicylic Acid, 30 grains. 
Betanaphthol, 15 grains. 
Oil of Cade, 30 grains. 
Resorcin, 30 grains. 
Zinc Oxide, 2 drams. 
Petrolatum, 1 ounce. 
Apply once or twice a day. 
94 CHAPTER XXIII. 
THE TREATMENT OF LEUCORRHEA 
OR WHITES 
The majority of women have some 
discharge from the vagina. At the men- 
opause it is often greatly increased in 
amount. 
The general treatment consists in 
general hygienic measures and common 
sense. The patient should not be on her 
feet more than she can help, and she 
should not walk until exhausted or fa- 
tigued. Where the leucorrhea is due to 
or is aggravated by anemia and general 
weakness, a good iron preparation, such 
as one Blaud's five-grain pill three times 
a day, or a tonic of iron, quinine and 
strychnine, will do good. A daily cold 
bath or cold sponge, followed by a brisk 
dry rubbing with a rough towel, is also 
useful. 
One of the simplest things is an alum 
tampon. You take a piece of absorbent 
95 TREATMENT OF LEUCORRHEA 
cotton, about the size of a fist, spread it 
out, put about a tablespoonful of pow- 
dered alum on it, fold it up, tie a string 
around the center, insert it in the vagina 
as far as it will go, and leave it in for 
twenty-four hours. Then pull it gently 
by the string and syringe yourself with 
a quart or two quarts of warm water. 
Such a tampon may be inserted every 
other day or every third day, and I have 
known cases where this simple treatment 
alone produced a cure. 
In some cases, however, douches work 
better and the two best things for douch- 
ing are tincture of iodine and lactic acid. 
Of the tincture of iodine, use one tea- 
spoonful in two quarts of hot water in a 
douche bag. This injection should be 
used twice a day, morning and night. Of 
the lactic acid, use two tablespoonfuls 
to one quart of water. The lactic acid 
has the advantage over the tincture of 
iodine that it is colorless, while the 
iodine is dark and stains whatever it 
comes in contact with. Sometimes it is 
advisable to use the tincture of iodine 
96 TREATMENT OF LEUCORRHEA 
and the lactic acid alternately; for one 
douche the tincture of iodine, for the 
next the lactic acid, and so on. When 
the condition improves, it is sufficient 
to use one tablespoonful of the lactic 
acid to two quarts of water. These in- 
jections are quite efficient and have the 
advantage of being perfectly harmless. 
97 CHAPTER XXIV. 
BAD ODOR FROM THE MOUTH 
The menopause may per se be the 
cause of a bad odor from the mouth. 
And if a bad odor existed before, the 
menopause may greatly aggravate it. 
A bad odor or a bad breath may be 
due to a variety of causes. It may be 
due to bad teeth, to pyorrhea (pus 
around the gums), it may be due to bad 
tonsils (chronically inflamed tonsils con- 
tain little cheesy masses which are full 
of germs and have an exceedingly of- 
fensive odor); it may be due to catarrh 
of the nose and throat, to disease of the 
lungs, to catarrh of the stomach or even 
to intestinal indigestion and fermenta- 
tion. It may be due to a combination 
of causes. The patient, if intelligent, 
can do a great deal for herself in the 
matter. A coated tongue should be 
scraped every two or three hours, if nec- 
essary, with a tongue scraper, and then 
98 TTREATMEI'fT OF BAD ODOR 
the surface of the tongue rubbed off with 
a piece of lemon. The mere scraping of 
the tongue removes billions of germs 
from the oral cavity. 
Diseased tonsils should be painted 
vigorously once a day with the following 
solution: 
Iodine, io grains. 
Potassium Iodide, 20 grains. 
Glycerin, 1 ounce. 
The same solution may be painted 
over the back of the throat in cases of 
chronic catarrh of the throat. The 
painting may be done with a long camel's 
hair brush, but preferably with a piece 
of cotton tightly wound on a long stick 
of wood. 
If there seems to be indigestion, ca- 
tarrh of the stomach, with fermentation 
of food, belching of gas and water brash, 
large doses of pure willow charcoal 
should be taken-say about a tablespoon- 
ful about an hour after each meal. 
The following combination is better 
than charcoal alone: 
Willow Charcoal, 4 ounces; Calcined 
99 TTREATMENT OF BAD ODOR 
Magnesia, 2 ounces; Subnitrate of Bis- 
muth, 1 ounce; Oil of Peppermint, 12 
drops. A tablespoonful one hour after 
meals. Take it dry on the tongue, then 
swallow just enough water to wash it 
down. 
A FEW ADDITIONAL FORMULAE 
In bad odor from decayed teeth, the 
following formula will be found useful: 
Thymol, 8 grains; Alcohol, i ounce; 
Glycerin, 4 drams; Sol. of Formalde- 
hyde, 8 drops; Water, to make 8 ounces. 
Use as a mouth wash. 
Or: Solution of Chlorinated Soda, 
11/2 drams; Glycerin, 4 drams; Pepper- 
mint Water, to make 8 ounces. Use as 
a gargle. 
In bad odor from gastric fermenta- 
tion, the following mixture has given 
satisfactory results: 
Creosote, 30 drops; Resorcin, 15 
grains; Alcohol, 4 drams; Chloroform 
Water, to make 3 ounces. Teaspoonful 
after meals in a little water. 
100 CHAPTER XXV. 
FOR LOSS OF HAIR 
During the menopause, the woman is 
often horrified to notice that her hair is 
coming out in bunches. If nothing is 
done, just a few straggly wisps may be 
left. But by energetic action, we may 
stop the further progress of the devas- 
tation. 
Massaging the scalp, if done properly 
and persistently, is unquestionably ben- 
eficial, and where the roots have not 
been destroyed, a new growth of hair 
may be brought about by proper mas- 
sage. But it must be done by a masseuse, 
as few people possess the patience neces- 
sary to massage one's own scalp for half 
an hour. 
After massaging, or at night on going 
to bed, the following lotion may be 
rubbed in: 
101 LOSS OF HAIR 
Chloral, i dram; Tannic Acid, i 
dram; Tincture of Cantharides, 2 drams; 
Glycerin, 4 drams; Alcohol, 8 ounces. 
If the skin of the scalp is dry, then in 
the above lotion use only 4 ounces of al- 
cohol and 4 ounces of castor oil instead 
of 8 ounces of alcohol. Quinine as a 
hair tonic is of no value. 
Endocrine preparations such as thy- 
roid and ovarian substance should be 
given a thorough trial, because there is 
no question that the sudden falling of 
the hair during the climacterium is due 
to disturbances of the ovaries and the 
thyroid. 
102 CHAPTER XXVI. 
TREATMENT OF HEMORRHOIDS 
The constipation of the menopause is 
apt to cause or to aggravate already ex- 
isting hemorrhoids. 
Hemorrhoids we know are a great 
nuisance and may render a person very 
wretched and irritable; while bleeding 
hemorrhoids, if the bleeding is frequent, 
may make the patient weak and anemic; 
if the bleeding is severe, they may be- 
come dangerous. Such hemorrhoids 
should be operated on. But there are 
certain kinds of hemorrhoids, where the 
patient can get along very well without 
an operation. Constipation, if any, 
should be treated with gentle measures. 
Avoid strong cathartics, because strong 
cathartics may be the cause of piles. In- 
jecting a quarter to a half a pint of cold 
water into the rectum twice a day- 
morning and night-is very useful. For 
the intolerable itching sometimes pres- 
103 TREATMENT OF HEMORRHOIDS 
ent in hemorrhoids, use the following 
ointment: 
Menthol, 3 grains; Calomel, 10 grains; 
Subnitrate of Bismuth, 30 grains; Resor- 
cin, 10 grains; Oil of Cade, 15 grains; 
Petrolatum, 1 ounce. 
The piles are well cleansed with hot 
water, and the salve is smeared over; a 
little is pushed into the rectum, and a 
piece of cotton is put over the anus; it 
is usually kept in place by the buttocks. 
The cotton protects the clothes from 
soiling and keeps the medicine in place 
for a longer time. The ointment may be 
applied three times a day. 
A very excellent application for ex- 
ternal hemorrhoids is Calamine Powder. 
Get in the drug store, say, two ounces of 
pure Calamine, (not Calomel), apply 
liberally to the piles and protect with a 
piece of cotton. The powder may be 
sprinkled on the cotton and then applied. 
A few such applications often shrivel up 
the piles, so that they become like a small 
tag of skin which causes no trouble. 
Instead of the ointment previously 
104 described, or in addition to it, a cocoa 
butter suppository may be used. The 
following is a good formula: 
Nutgalls (finely powdered), 3 grains; 
Oil of Cade, 3 drops; Resorcin, 1 grain; 
Subnitrate of Bismuth, 5 grains; Cocoa 
Butter, 20 grains. 
This is for one suppository. Having 
made up two dozen such suppositories, 
insert a suppository into the rectum 
twice a day-night and morning (after 
the bowels have moved). In severe 
cases, three suppositories a day may be 
used. There are on the market ready 
made, hemorrhoidal suppositories (an- 
usol, bismolan, etc.) which are quite 
good and may be relied upon. 
105 CHAPTER XXVII. 
OFFENSIVE PERSPIRATION 
On account of the disturbances of the 
circulation and of the glandular secre- 
tions, the feet may become very offen- 
sive, nauseatingly so. 
Mild cases of excessive or offensive 
perspiration of the feet should be treated 
as follows: Soak the feet for 5 or 10 
minutes every night in cold water, con- 
taining some alum or common salt (a 
handful or two of alum, a handful or 
two of salt, to a basinful of water); dry 
and rub well with alcohol; then put on 
dry fresh socks or stockings. If the skin 
between the toes is softened and broken 
("macerated"), put a pledget of cotton 
soaked in alcohol between each toe. In 
the morning rub the feet with the fol- 
lowing powder, and shake some of the 
same powder into the socks: 
Salicylic Acid, 1 dram; Boric Acid, 1 
ounce; Dried Alum, 2 ounces; Talcum, 
4 ounces. 
106 OFFENSIVE PERSPIRATION 
In the more severe and obstinate case9 
of excessive perspiration with foul odor, 
the feet should be soaked in a solution 
of permanganate of potassium-% ounce 
of the permanganate to 2 quarts of wa- 
ter; soak for 10 to 15 minutes; the feet 
will acquire a brown color; do not try 
to rub it off; it will come off by itself. 
Do this for several nights in succession, 
using the powder in the daytime. The 
socks should be changed every day. In- 
stead of potassium permanganate, we 
may use formaldehyde in very severe 
cases; two tablespoonfuls of solution of 
formaldehyde (such as one gets in the 
drug stores-40 per cent strong) to a 
quart of water. 
107 CHAPTER XXVIII. 
TYPE CASES 
Case One 
She began to menstruate when she 
was a few days past her thirteenth birth- 
day. There was no pain, no premen- 
strual symptoms; it just came on. Her 
mother prepared her for the eventuality 
and she was not frightened or embar- 
rassed. After that she menstruated 
regularly every twenty-eight days. Reg- 
ularly like clockwork on the twenty- 
eighth day she would get her period. No 
headaches, no backaches, no symptoms 
of any kind. 
Whenever she would miss a period she 
would know that she was pregnant; the 
menses would stay away during the 
pregnancy, and for the first six or seven 
months afterwards during lactation. 
Then they would become re-established, 
and would again occur regularly like 
clockwork. 
108 TYPE CASES 
At the age of forty-nine, the periods 
became somewhat more scanty, lasted 
only two or three days at a time; then 
she skipped two periods, and then the 
menopause was permanently established. 
She had no symptoms of any kind what- 
ever. No flushes, no sweats, no head- 
aches or vertigo, and she was not any 
more peevish or irritable than at any 
other time of her life. And now she is 
as healthy and serene as she ever was; 
perhaps more so. 
Case Two 
At the age of forty-four she began to 
have disagreeable flushes of the face and 
neck. The people about her noticed that 
she became irritable and was harder to 
get along with than before. These symp- 
toms lasted for about a year before there 
was any change in her menstrual periods. 
Then the menstrual periods became ir- 
regular, scanty, accompanied with pain 
and backache, and her flushes became 
more frequent and more intense. She 
109 TYPE CASES 
would have them twice or three times 
a week. Also suffered from occasional 
insomnia. A slight leucorrhea also made 
its appearance, which caused her fur- 
ther annoyance. There was also some 
itching around the genitals. 
After three or four years, all these 
symptoms disappeared, the menopause 
was firmly established, and the patient 
was as normal as before the podromal 
symptoms of the menopause made their 
appearance. 
Case Three 
At the age of forty-five to forty-six the 
people began to notice a great change in 
her. And she herself was aware of it, 
but she said that she could not help it. 
She became so irritable that the least 
trifle would throw her into tantrums. 
She quarreled with friends and with 
members of the family. She became in- 
tensely jealous of her husband and of 
her own children, and very suspicious. 
She began to suffer with intense insom- 
110 TYPE CASES 
nia, which resisted treatment. That ag- 
gravated her condition, made her more 
irritable, made her lose her appetite, 
which aggravated her constipation to 
such an extent that it would respond to 
no ordinary doses of cathartics. She had 
to take either excessive doses of hyper- 
cathartics, or large enemas to induce a 
movement; and these things weakened 
her. Which again aggravated her psy- 
chic condition. She began to suffer 
from unbearable headaches, which would 
now and then be accompanied by nausea 
and vomiting. Later on she began to 
suffer from vertigo and migraine. En- 
ormous doses of coal-tar products had 
to be administered before the migraine 
would be relieved, and she had often to 
stay two or three days at a time in a 
darkened room to cut short the dura- 
tion of the headaches and the migraine. 
Her flushes were a veritable torture 
to her, for they gave her no respite. She 
would have them a dozen, forty, fifty, 
one hundred times a day. She would 
have them all over the body, not merely 
111 TYPE CASES 
over the neck and face. First, she would 
claim that she was stifling from the heat, 
and she would demand that the win- 
dows be opened so that she could get 
some fresh air; then she would be bathed 
in profuse perspiration, which she would 
claim felt at first like a hot bath and 
then like a cold shower. 
She would be extremely depressed and 
irritable after these attacks. And she 
would have them both day and night; 
during the night they of course con- 
tributed to her insomnia, as did the se- 
vere itching which she developed. 
She also developed a severe leucorrhea, 
which was followed by an intense prur- 
itus vulvae et vaginae. Nothing seemed 
to help her, probably because of the in- 
somnia. She complained that unless 
something was done for her, she would 
go insane, because she could not stand it 
to be up all night and suffer from the in- 
tense itching. Only the most violent 
scratching which would cause numerous 
bleeding points would give her any 
relief. 
112 TYPE CASES 
She would repel the solicitude of the 
husband and the children, claiming that 
they did not care for her, that they en- 
joyed seeing her suffer. 
Her menses, at first scanty, would now 
and then develop into regular uterine 
hemorrhages. She became extremely 
thin and pitiful-looking. 
Within two or three years she aged 
at least ten years. Her hair, quite black 
prior to the onset of the menopause, be- 
came rapidly gray. It is no hyperbole 
to state that her change of life did 
change her into a different woman. Her 
mind was clear and normal, but in every 
other respect she was different. 
These various symptoms in various 
degrees of intensity and frequency, 
lasted for about seven years. Then they 
gradually disappeared, she became again 
normal, though she was, of course, a 
much older woman; and she was more 
depressed-or perhaps a better term 
would be subdued-than she was before 
the menopause. 
113 TYPE CASES 
Case Four 
The patient of this type had most of 
the symptoms of Type Three. But in 
addition, the leucorrhea and the hemorr- 
hages she had were more profuse and 
painful, and an examination showed that 
she was developing cancer of the uterus. 
This patient was unmarried, she be- 
came deeply melancholic, and committed 
suicide by drowning, after leaving a 
note that she had nothing to live for. 
Case Five 
Also an unmarried woman. At the 
age of forty-three, when the menopause 
began to make its appearance, she be- 
came intensely erotic, at first imagining 
that different men wanted to violate her, 
and then making open accusations 
against different men, some of whom 
she had never seen or met. 
She gradually became violently insane, 
114 TYPE CASES 
and had to be committed to an asylum, 
where she still is. 
There was an hereditary tendency to 
insanity in her family; her mother was 
not quite normal, but the husband and 
the children took care of her; and two 
of her aunts were paranoiacs. 
The above five types present quite 
fully the various symptoms that we come 
across during a woman's menopause. 
Type One is the ideal type, and we 
can but wish that all women belonged 
to this type. Perhaps in the future they 
will. Unfortunately, only a small per- 
centage of women have such a smooth, 
serene menopause. The greatest num- 
ber of women belong to the second type. 
This may be called the normal type for 
women of our race and civilization. A 
gradually diminishing percentage be- 
long to Types Three, Four and Five, and 
it is to be hoped that with the increase 
in medical, psychologic and sexologic 
knowledge, and with the improvement 
115 TYPE CASES 
in social, economic and moral conditions, 
cases in these categories will become 
fewer and fewer, until they will have 
disappeared altogether 
I am a great believer in the influence 
of knowledge and environment on health. 
116 CHAPTER XXIX. 
AVERAGE CASES 
Case Six 
Age 56. Last menstruation at the age 
of 49. Claims that she does not know 
that there is such a thing as "change of 
life." For with the exception of the 
cessation of the menses, she has exper- 
ienced no disagreeable symptoms what- 
ever. No headaches, vertigo, flashes of 
heat, palpitation, etc., of which so many 
of her lady friends complain. She cer- 
tainly looks al least as well as she did 
ten years befone. Skin clear, and fewer 
wrinkles, due to the fact that she is 
slightly plumper than she was. 
This woman believes that all symp- 
toms of the menopause of which women 
camplain are in the women's imagina- 
tions. It is always thus; the person who 
has never experienced a pain or a dis- 
agreeable symptom, not only has no sym- 
pathy with those who have, but is apt 
to be sceptical ajout the genuineness of 
the people's suffering. 
117 AVERAGE CASES 
Case Seven 
Beginning of menopause at 45. Com- 
plete cessation of menses at about 46%. 
At the age of 46 married a man five 
years younger than herself, and has been 
living happily ever since. Looks better 
than she did at the age of 35 or 40. 
Case Eight 
Age 54. Began to menstruate at the 
age of 12%, and has been regular as 
clockwork since then. Hardly ever a 
day overdue or premature. Six normal 
pregnancies. No menstruation during 
pregnancy or lactation. 
At the age of- 51, menses became some- 
what irregular, appearing for only two 
or three days, five or six weeks apart. 
Occasional flushes and slight headache. 
At the age of 51 years and 10 months, 
the last menstruation appeared. Since 
then no sign of catamenia. Woman in 
perfect health and in good spirits. More 
118 AVERAGE CASES 
cheerful even than before-or perhaps 
the word cheerful is not exact; the word 
serene is more appropriate. Sexual rela- 
tions the same as throughout her entire 
married life-that is, she claims that she 
has the same libido and experiences the 
same enjoyment. 
119 CHAPTER XXX. 
THE MENOPAUSE AND SERENITY 
Case Nine 
A highly cultured and educated vir- 
gin of forty-five. The dreaded forty-five. 
A year and a half ago, her menses be- 
came irregular, and about six or eight 
months later they ceased altogether. 
No catamenial sign or symptom since. 
Do you know how she took it? She took 
it with the utmost composure. "I am 
glad the blamed thing is over. What 
good did it do me? None. It was only 
a monthly nuisance. I am glad it is 
over." 
And she continued with her chosen 
work, more enthusiastically, more ener- 
getically than ever. Her femininity 
never meant anything to her as far as 
any satisfaction is concerned, and now 
she put her sex life beyond an iron door 
and threw away the key. Some women 
who have their chosen work which they 
love can do that. 
120 AVERAGE CASES 
Case Ten 
THE MENOPAUSE, SEXUAL AVERSION 
AND RETURN TO NORMAL 
Never strongly sexed, she neverthe- 
less lived with her husband for over 
twenty-five years, always fulfilling her 
"marital duties" (what a fine expression 
this is!) But from the first manifesta- 
tion of the menopause, at the age of for- 
ty-six, she has the deepest aversion to any 
sexual approach. Not only does she per- 
mit no intercourse, but she does not al- 
low her husband to touch her. Any at- 
tempt to overcome her resistance results 
in screaming, hysterics, fighting, throw- 
ing things about, etc. The husband is a 
soft and rather fine fellow, who does not 
believe in extra-marital relations; but 
he is still vigorous sexually, and he does 
not know how to get out of the difficulty. 
His utter neglect of his wife for six 
months, his leaving her severely alone 
sexually, his making her believe and not 
121 AVERAGE CASES 
denying her accusations that he was get- 
ting satisfaction elsewhere, brought her 
about very nicely. And what is more, 
she claimed that she now enjoyed sexual 
relations even more than she did before 
the menopause. 
Case Eleven 
THE MENOPAUSE AND THE SEXUAL END 
Virgin. Menopause between forty- 
three and forty-four. Since then abso- 
lutely no sexual desire, no longings, feels 
quite calm as far as sexual matters are 
concerned. Never strongly sexed; be- 
gan to menstruate at the age of sixteen, 
first sexual desire at the age of about 
twenty-four; after that generally for a 
day or two during the beginning of the 
menses. Never masturbated; never had 
any sexual relations. 
Case Twelve 
THE SAME AS PRECEDING CASE 
Married twenty-two years. Quite 
122 AVERAGE CASES 
passionate. Menopause at forty-eight. 
Since then no desire and no feeling, 
though she does not refuse sex relations 
to satisfy her husband. Has had six 
children. Cervix badly torn. 
I do not know why it should be so, but 
I have seen quite a number of cases in 
which a lacerated cervix seemed to be 
the cause of the loss of libido. And I 
have seen two cases in which repair of 
the torit cervix was followed by return 
of the libido. 
123 CHAPTER XXXI. 
THE MENOPAUSE AND MASTURBATION 
Case Thirteen 
Age 55. She was happily married, 
lived with her husband twenty-six years, 
had several children, and always enjoyed 
very good health in spite of a rather 
annoying and obstinate leucorrhea. 
With the onset of the menopause, she 
began to masturbate, first moderately, 
then excessively-daily, occasionally 
three or four times a day. Normal co- 
itus neither satisfied her, nor diminished 
the desire for masturbation. Treatment 
proved of no avail. When she tried to 
refrain, she felt very wretched; much 
worse than when she masturbated. One 
doctor finally told her that she may con- 
tinue, provided she does not indulge ex- 
cessively. She continued the practice 
once a day, then once in two or three 
days; when the menopause was fully es- 
tablished, she ceased masturbating and 
returned to normal coitus. 
124 MENOPAUSE AND MASTURBATION 
We have many cases of women who 
begin their first masturbation during the 
menopause. And some who masturbated 
as girls and gave up the practice, return 
to it during the change of life. 
Case Fourteen 
Age 46. This case is similar to the 
preceding, except that the patient was a 
virgo Intacta. She had never had any 
relations, and the hymen was intact. 
She suffered severely, not as a result of 
the masturbation, but because slie feared 
that the habit was injuring her and that 
she might get insane. When assured that 
her fears were groundless, that she might 
continue the practice in moderation 
without any injury, she felt at once bet- 
ter. With the final cessation of menstru- 
ation, and with the improvement of an 
annoying leucorrhea, she gave up1 the 
habit without much difficulty. 
Case Fifteen 
Age 48. Quite normal sexually to the 
age of 44. Not exceptionally passion- 
125 MENOPAUSE AND MASTURBATION 
ate, but always enjoyed sexual relations. 
Became indifferent at about the age of 
40. Cessation of menstruation at the 
age of 45, and since then absolutely no 
sexual feeling of any kind. No aversion, 
and does not repel the husband, but has 
no desire for sex relations, and no feel- 
ing or orgasm during the act. 
However, about a year or two ago be- 
gan to masturbate, and masturbation 
does give her considerable pleasure. She 
masturbated between the ages of fifteen 
to about twenty. 
126 CHAPTER XXXII. 
THE MENOPAUSE AND ABNORMAL LIBIDO 
Case Sixteen 
Married at the age of twenty. Meno- 
pause at fifty. For the first ten years of 
married life very little sexual desire; in 
fact, none at all, only to satisfy husband. 
After that gradually increasing desire 
for the act and gradually increasing en- 
joyment during the act. But since the 
menopause, the libido is so strong that 
husband cannot possibly satisfy her. 
Failure to accede to her demands, or 
failure to induce orgasm, makes her 
peevish, angry and sometimes highly 
hysterical. Threatens to get satisfaction 
elsewhere, and husband, either because 
he is a radical or because he is really 
anxious to be left alone and not to be 
overexhausted, gives his full consent. 
Case Seventeen 
Age 47. Unmarried. At the age of 
127 ABNORMAL LIBIDO 
42 or 43, menstruation became irregular, 
painful, and the libido became so strong 
and uncontrollable that she became scan- 
dalously dissolute. At first, she tried to 
conceal her transactions, but afterwards 
she threw all prudence to the winds, and 
rather advertised the fact that she was 
to be had by anybody who wanted her. 
Case Eighteen 
Age 44. Unmarried. Similar to the 
previous case. Began to have her meno- 
pause at the age of 39. Gradually in- 
creasing libido, until it reached nympho- 
maniac proportions. Became very dis- 
solute, and finally entered house of pros- 
titution, where she lived for a number 
of years. 
128 CHAPTER XXXIII. 
THE MENOPAUSE AND FREE SEXUAL LIFE 
Case Nineteen 
Though she was of an extremely pas- 
sionate nature, yet she led a strictly chaste 
life, and never was there a breath of 
scandal against her. She lived in a small 
town, where everybody knew everybody 
else, and a r .picion against any woman's 
purity meant social ostracism. As to 
pregnancy in an unmarried woman of 
her social standing-why, a dozen deaths 
would have been preferable. She might 
not have minded the social ostracism, 
but the fear of pregnancy did have, as 
it often has, the proper inhibitory effect. 
With the full establishment of the 
menopause, however, the lady began to 
lead a very active sexual life. The fre- 
quency of her indulgence was limited 
only by the number of the opportunities. 
And the improvement in her physical 
129 A FREE SEXUAL LIFE 
appearance was remarkable to behold 
And so was the improvement in her 
mental and spiritual condition. Only 
now she began to live, and she knew what 
life meant. This woman took her 
"change of life" into her own hands, 
escaped the shoals and rocks which 
threaten so many other women and came 
safely on shore. 
THE MENOPAUSE AND ELOPEMENT 
Case Twenty 
At the age of fifty, this woman who 
had had an ideal life with her husband 
for a quarter of a century, who was the 
mother of three children, suddenly left 
her home, and went to live with a worth- 
less and penniless scamp. (She had 
plenty of money.) The husband was 
heartbroken. He suffered particularly 
because he knew of the worthlessness of 
the man whom the wife idealized. She 
believed that he was deeply in love with 
her, and she resented as a deep insult to 
130 A FREE SEXUAL LIFE 
her womanhood and her judgment any 
intimation that Mr. X. might have ul- 
terior motives. All solicitations and ar- 
guments of the husband, children and 
friends were in vain. She lived with 
this quasi-poet for about six months. 
She finally saw through him; a certain 
incident showed her that he was a moral 
skunk. She left him at once. She wan- 
dered about for another year. Then she 
came back to her husband. She knew 
that he would be happy to welcome her 
back and he was. He took the whole 
thing for a temporary aberration of the 
mind-or the emotions-and they lived 
as happily as ever before; perhaps more 
so. 
131 CHAPTER XXXIV. 
THE MENOPAUSE AND JEALOUSY 
Case Twenty-one 
This case is of more than ordinary im- 
portance for several reasons. It is in- 
teresting per se, it illustrates one of the 
commonest troubles during the meno- 
pause period, and it offers proof-if fur- 
ther proof were needed-of the tremen- 
dous influence of the mind over the body. 
She was 48, he was 52. And up to 
about two years ago they lived happily 
together. She was the mother of four 
children, all alive and healthy. He was, 
as an analysis of the case shows later, 
of the non-sexual type. He was not 
a-sexual, or impotent, but merely sex 
did not play much of a role in his life. 
He was devoted to his business, to his 
home, and to his books, and had no out- 
side interests. 
Sexual relations were had about once 
in two weeks; during the past 10 or 12 
132 MENOPAUSE AND JEALOUSY 
years about once a month. The wife was 
quite satisfied and never even once did 
she have any fault to find with the in- 
frequency of the relations. About two 
weeks prior to my seeing the husband, 
she became peevish, angry, and began to 
show signs of jealousy. The jealousy be- 
came so intense that the poor man did 
not know what to do. All assurance of 
his loyalty, of his unswerving fidelity, 
had no effect on her. The man ridiculed 
the notion of his being unfaithful to her, 
and swore that he had absolutely no de- 
sire for any other woman, that they did 
not interest him. It was of no avail. He 
began to stay in the house more than 
ever; he managed it so that she knew 
practically every minute where he was, 
and yet that did not convince her. 
When he began to demand of her the 
reasons for her jealousy, she at first re- 
fused to give any reasons or explanations. 
Simply she knew that he was unfaithful. 
Finally, it came out that the grounds 
for her jealousy and her belief in his un- 
faithfulness, were based upon the fact 
133 MENOPAUSE AND JEALOUSY 
that during the two years past he had 
practically no relations with her. Per- 
haps once in two or three months, while 
during the past eight months not even 
once. That convinced her that he must 
have had another woman. 
Unfortunately her libido, due to the 
oncoming of the menopause, became in- 
tensified. And the jealousy intensified 
it, as it often does, still further. All as- 
surances, all affirmations on the hus- 
band's part, were of no avail. He as- 
sured her that he had absolutely no sex- 
ual desire and no sexual power. She did 
not believe him. The poor man then 
came to me for consultation and treat- 
ment. He wanted to know if he could 
be cured of his impotence. He frankly 
stated that as far as he was concerned, he 
was quite satisfied with his condition; he 
never was particularly keen in sexual 
matters, and now he had absolutely no 
desire and no feeling. He would prefer 
to forget all about it, but for the sake of 
his wife, for the sake of peace in the 
family, he would like to be treated. 
134 MENOPAUSE AND JEALOUSY 
I saw that it was a case of normal 
physiologic decay. I felt that nothing 
could be done to restore the potentia 
coeundi, even if the libido could be 
stimulated. And I told him so. Still, 
for the sake of his wife, whom he loved 
tenderly, he was willing to take a chance 
and undergo any treatment regardless 
of trouble and the length of time re- 
quired. After two months' treatment, I 
told him, and he saw himself, that it was 
useless to treat him any further. He felt 
quite distressed. 
Fortunately, his wife had found out 
that he was being treated by me. She 
called me up to inquire if she could come 
around to find out something about her 
husband. I inquired of the husband if 
I could give her all the information 
about him. Of course, he was only too 
glad to have her informed of the true 
state of affairs. She came, I told her the 
truth about her husband's condition. A 
heavy burden fell off her mind, harmon- 
ious relations were at once re-established. 
And here is the interesting point, illus- 
135 MENOPAUSE AND JEALOUSY 
trating the power of the mind over the 
body. Her libido became at once dim- 
inished, and within a few weeks became 
completely extinguished, so that she did 
not care for sexual relations any more 
than her husband did. 
There are thousands of households in 
which the husband's dying libido and 
oncoming impotence are misinterpreted 
by the wife as proofs of infidelity. Much 
misery could be avoided if the truth 
could be brought home to them that a 
very large percentage of men, particu- 
larly of the intellectual type, do become 
impotent between the ages of 45 and 55. 
A woman may lose her libido and still 
be perfectly fit for sexual relations-a 
woman can never become impotent in 
the sense that a man can. But when a man 
is impotent, he impotent. 
136 CHAPTER XXXV 
THE MENOPAUSE AND HOMOSEXUALITY 
Case Twenty-two 
Forty-six years old. Unmarried. Vir- 
gin. Never cared much for men. Sex- 
ually, she claims, not at all, but likes 
their company. Since two years, men 
utterly distasteful; sexually repulsive. 
More and more attracted to women. 
During the past six months has been liv- 
ing with a woman in the thirties in homo- 
sexual relations. 
Cases in which unconscious, hidden or 
marked homosexuality breaks forth 
openly and actively during the meno- 
pause are not infrequent. It is, however, 
well to bear in mind that in some cases 
the homosexuality is not physical, only 
emotional, and a female companion is 
selected faute de mieux, because the wo- 
man is unable to get a male mate, or is 
too proud to attempt to get one, and 
the need for some emotional outlet is 
137 HOMOSEXUALITY. 
desperately great. This variety of "ho- 
mosexuality"-I believe homo-emotion- 
ality would be a more correct term-is 
analagous to the cases which develop 
in circumstances, when one sex is thrown 
wholly upon itself' - in barracks, 
prisons, training vessels, non-coeduca- 
tional boarding schools, and so forth. A 
case is also known to us of a woman who 
had been married for about ten years, 
lived fairly happily-at least on the sur- 
face-with her husband, and during the 
the menopause began to display strong 
homosexual tendencies. There was a di- 
vorce and the woman went to live with 
a girl of well-known homosexual in- 
clinations. 
138 CHAPTER XXXVI. 
THE MENOPAUSE AND RESTLESSNESS 
Case Twenty-three 
She is forty-five, going on forty-six. 
People are wondering at the change 
which has taken place in her. She had 
been a very quiet little person. Rather 
shy, retiring, and seldom seen outside 
the schoolroom and her little home. 
And suddenly-as a friend said-what 
devil got into her? Constantly picking 
quarrels, getting into tantrums, having 
violent crying spells, tearing her hair, 
and then always on the go. Running 
about shopping, buying useless things, 
returning them, exchanging tKem, re- 
turning the exchanges; going practically 
every night to the theatre or to concerts 
or to lectures; doing everything to tire 
herself out, then coming home late at 
night, sobbing for hours, and passing 
sleepless, restless nights, tossing about, 
getting up, reading, throwing down the 
139 RESTLESSNESS IN THE MENOPAUSE 
book, dressing and sitting at the window 
waiting for the dawn. And she is driv- 
ing her old mother to distraction, and 
her two younger sisters are just "getting 
sick" of her. For she scolds them, makes 
sneering remarks about their gentleman 
friends, hides or throws out of the win- 
dow their rouge and paint sticks; in 
short, has become a nuisance to herself 
and to all around her. And yet she is 
not a bit crazy; she is merely terribly ir- 
ritable; in a state of unstable nervous 
equilibrium. 
And it is not at all so hard to under- 
stand the change that has taken place 
in her. While very shy and timid, she 
was not shy and timid in her imagination. 
There she let herself loose. She was al- 
ways romancing, always expecting a 
hero-lover husband. The years passed, 
yet she hoped, and hoped. Suddenly 
she saw the dreaded change of life com- 
ing on; she saw her youth, her potential 
love life, her potential motherhood slip- 
ping away. Consciously or unconscious- 
ly-though there is no occasion for call- 
140 RESTLESSNESS IN THE MENOPAUSE 
ing the unconscious into service-she 
knew that what she day-dreamed for so 
many years would never become a real- 
ity, that never, never would she be in 
the arms of a man; never, never would 
her lips be touched by the fire of the pas- 
sionate kisses of an ardent man. And 
on top of all, her libido, always of normal 
intensity, began to burn like a flame. 
At times it was more than she could 
stand, and autoerotic activity gave her 
slight physical relief, but left her psych- 
ically in an even worse state. No won- 
der she felt frantic, hysterical and be- 
haved the way she did. With her body 
and her psyche you would feel and be- 
have exactly the same way. Perhaps, if 
you had less will power than she, you 
would behave worse. 
141 CHAPTER XXXVII. 
THE MENOPAUSE AND MELANCHOLIA 
Case Twenty-four 
Forty-nine years old. Married at the 
age of twenty-seven. Husband two 
years younger. Two children, boy and 
girl. Boy dead at the age of three years 
from diphtheria; girl alive and healthy, 
eighteen years old. Mother and daugh- 
ter never got along well. Mother al- 
ways hard working, she and her husband 
get along well, he usually giving in in 
everything. Sex relations mutually sa- 
tisfactory. 
Three years ago she began to have 
change of life and began to act queerly. 
First change noticed, she refused to per- 
mit sex relations; then she refused to 
have husband sleep in same bed. Then 
she became terribly cranky and nagging, 
so that the daughter had to move out 
from the house and was living with an 
aunt. All day talking and finding fault. 
142 MENOPAUSE AND MELANCHOLIA 
"She drove away all our friends, men 
and women, so that nobody visits us any 
more." A year ago she pawned all her 
jewelry, also some of the silver in the 
house, took out all the money she had 
saved up from the savings bank, and dis- 
appeared. She left no trace. 
For six months they did not hear from 
her; then one evening she arrived with a 
little valise, went up to her room and 
stayed there for about two months. Her 
meals had to be brought up to her, as 
she refused to leave the room. Most 
of the time she stayed in bed, and re- 
fused to speak to anybody. She would 
not permit a doctor to examine her, nor 
would she take any medicine. One doc- 
tor advised to give her very little food, 
in the hope that hunger might oblige 
her to ask for food, or force her to leave 
the room and go downstairs to the 
kitchen and the dining room. It didn't 
work. She became very thin, but she 
guarded her silence and her room. She 
kept it up for about four months. Then, 
one morning, she went downstairs and 
143 MENOPAUSE AND MELANCHOLIA 
prepared breakfast. Since then she has 
been acting normally. She is still de- 
pressed, and at times taciturn, but she 
does not repel her husband, and she ex- 
pressed once a desire or her willingness 
to see her daughter. She seems to be ac- 
quiring poise, and even a little serenity. 
There can hardly be any doubt that we 
have here to deal with a case of melan- 
cholia of climacteric origin. The meno- 
pause was the etiologic factor, and when 
that period is completely over, when the 
woman enters into her post-climacteric 
years, she will probably be as normal as 
she was before the menopause. 
144 CHAPTER XXXVIII. 
THE MENOPAUSE AND KLEPTOMANIA 
Case Twenty-five 
Of exemplary rectitude and of the 
strictest behavior all her life, she devel- 
oped kleptomania soon after her forty- 
fourth year, when her menses became 
scanty and irregular. It cost her the 
greatest effort to resist the temptation 
to steal, and on two or three occasions 
the temptation was stronger than her 
will power, and she stole. She felt dis- 
tressed and returned the articles, and 
she was careful not to go to places where 
there was a possibility of stealing. 
This mania lasted for about two 
years. After the climacteric was fully 
established, the kleptomania disap- 
peared, and has never returned. 
145 CHAPTER XXXIX. 
THE MENOPAUSE AND PERSECUTION 
OF MEN 
Case Twenty-six 
That both priests and physicians are 
often annoyed and endangered by wo- 
men in the climacteric, particularly un- 
married women, is well known. The 
following case is well known to me. 
A woman forty-six years of age came 
to a physician's office to be examined. 
Very soon screams were heard; she ran 
out disheveled, crying that the doctor 
tried to assault her. She was not satis- 
fied with the mere accusation, but lodged 
a formal complaint. The doctor was 
arrested. And of course, his charitable 
professional colleagues thought "there 
must be something to it." The doctor 
felt worried, for you never can know how 
a judge and jury may look upon a case, 
what they may consider evidence. When 
the case came to trial, the plaintiff's own 
146 PERSECUTION OF MEN 
sister gave testimony which cast doubt 
on the woman's truthfulness. She stated 
that her sister had been acting queerly; 
that she would come home and tell that 
when she was in the subway, men were 
making love to her; one tried to take 
liberties with his hands, another asked 
her for her address and wanted her to 
go up to his room with him; whenever 
she would go to the movies, she would 
come back with stories of men trying to 
play with her, kiss her, and make ap- 
pointments. And when the doctor and 
the complainant were seen together, the 
thing looked too absurd. The doctor 
was a man of forty, fine looking, dainty, 
rather dandified. The woman had a 
hard, coarse face; she looked slouchy 
and slovenly, fat and stodgy; she had no 
more of a waistline than a barrel. The 
case was dismissed. 
The doctor afterwards stated that the 
woman, whom he had seen and pre- 
scribed for once or twice before she 
came in to be examined, when she was 
on the table, asked him to have relations 
147 PERSECUTION OF MEN 
with her. He gently told her that that 
could not be. It is then that she became 
wild. A few months later the woman 
repeated the same thing with another 
physician. The man was arrested. The 
case was thrown out when the woman's 
antecedents were brought to light. The 
woman's relatives were told that if she 
repeated the performance once more, 
she would be sent to an asylum or to jail. 
She was sent away to a private sani- 
tarium, where she still is. 
There are a number of cases on record 
of climacteric women who accused phy- 
sicians, clergymen, teachers and others 
of attempts on their virtue; though the 
cases were dismissed, still the damage 
done to the falsely accused men was ir- 
reparable; people are vicious and like to 
believe the worst; the usefulness of the 
doctor or the pastor in that community 
was gone, and they had to move away, or 
even change their occupation. 
That vicious and untrue proverb, 
"Where there is smoke there must be 
some fire," has done a great deal of 
148 PERSECUTION OF MEN 
damage to men's and women's reputa- 
tions. 
Case Twenty-seven. 
The following case is reported by Dr. 
C. A. Magian. 
A young and enthusiastic minister in 
the course of his parochial duties came 
into contact with a middle-aged spin- 
ster suffering from severe emotional dis- 
turbances of the menopause. Under the 
pretence of religious needs, she induced 
him to visit her frequently, and on such 
occasions took care to be alone in the 
house. Finally, she locked him in the 
room with her and divested herself of 
all clothing in the hope of obtaining sex- 
ual satisfaction . When this was indig- 
nantly refused, she raised an outcry and 
brought in the neighbors, accusing the 
clergyman of an attempt at rape. The 
circumstances of the case were inquired 
into by the bishop of the diocese, and the 
149 OBSTINATE INSOMNIA 
young man acquitted of all blame, but 
the publicity of the affair caused him 
such acute mental anguish that he re- 
signed his living and left the district. 
A few months later the woman com- 
mitted an act of public indecency and 
was removed to an asylum. The par- 
ishioners, some of whom had previously 
been sceptical of their late minister's in- 
nocence, then unanimously signed a pa- 
per expressing their regret at what had 
happened and their good wishes for his 
future. But the damage had already 
been done and could never be fully com- 
pensated for. 
THE MENOPAUSE AND IMAGINARY LOVERS 
Case Twenty-eight 
Unmarried lady. Age 45. Mesntru- 
ation irregular during the past three 
years. 
Imagines that every man looks at her 
lustfully, tries to excite her sexually, and 
at least a dozen have, according to her 
statement, fallen in love with her during 
the past year or two. Is a pest to all her 
150 PERSECUTION OF MEN 
male and female friends, so that they try 
to avoid her whenever possible. A phy- 
sician acquaintance, used to frank and 
even brutal talking whenever the occa- 
sion requires, told her plainly that she 
was lying and making a fool of herself, 
and gave her a book to read which he 
hoped would explain to her her actions 
and her feelings. Whether her feelings 
and beliefs have changed is not known, 
but her actions are less queer. 
151 CHAPTER XL. 
THE MENOPAUSE, INSOMNIA AND 
SUICIDE 
Case Twenty-nine 
She was having a very hard time with 
her change of life. She had been to a 
number of doctors. The flushes, chills 
and profuse perspiration annoyed her 
terribly. Sometimes the perspiration 
would be so hot, that she would com- 
plain that she felt as if she were drenched 
with a pail of boiling water; at other 
times she would have a cold sweat, and 
shiver all over. She had suffered with 
migraine before, but now the trouble was 
terrible. Only very large doses of ace- 
tanilid, phenacetin, pyramidon, and caf- 
feine would afford her any relief. But 
worst of all was her insomnia. That was 
so obstinate that veronal in 15 grain 
doses would have no effect. Only large 
doses of morphine and chloral would put 
her to sleep. And this the doctors re- 
152 OBSTINATE INSOMNIA 
fused to give her frequently. They were 
afraid that she might become a morphine 
addict. Once she had not closed her 
eyes for three nights in succession, and 
she said that she would do something 
desperate unless something was done for 
her. And she acted like an insane 
person. 
The following day she disappeared, 
and a little later she was found in the 
river. 
Some might call this a case of climac- 
teric insanity. But there was a psycho- 
pathic taint in the family. One brother 
and one uncle had committed suicide, 
and one sister was epileptic. The cause 
of the father's death is uncertain, but 
from the history it appears that he was 
syphilitic. 
153 CHAPTER XLI. 
SOME MISCELLANEOUS CASES 
Case Thirty 
She had six children, and eleven abor- 
tions. The husband refused to use any 
prevenceptives, she did not know of any 
efficient ones, and as she made up her 
mind rather to die than to have another 
child, she visited an abortionist regularly 
as soon as she was overdue. And yet her 
menopause passed smoothly without a 
ripple. Irregular periods for a few 
months, then they stopped and for good. 
No headaches or backaches, no flushes, 
no nervousness. Her childbearing per- 
iod was bad enough, and she feared that 
she would have a hard time with her 
change of life, and she was truly grateful 
that she was let off so easy. 
Case Thirty-one 
Lived harmoniously with her husband 
and children for over twenty years. At 
154 MISCELLANEOUS CASES 
the age of forty-five she packed up and 
left, and nothing would persuade her to 
come back. She had nothing whatever 
against her husband, she said; he was 
everything that a husband should be, but 
she just 'wanted to be alone. She was 
tired of having a man always around 
her. 
Her life alone was irreproachable; 
there was no other man in the case. She 
just wanted to be alone. She lived alone 
for four years; then the husband died, 
and she returned to the house and the 
children. Whether or not she would 
have returned if the husband had re- 
mained alive, will, of course, remain an 
unanswered question. 
Case Thirty-two. 
She had always been as normal as 
most women who remain permanently 
unmarried. She was interested in social 
and charitable work, and loved by chil- 
dren. She probably would have made a 
fine mother; but it was not to be. Many 
155 MISCELLANEOUS CASES 
potentially fine mothers go to waste 
under our social system. 
In the midst of her menopause, she de- 
veloped an affection, which amounted 
almost to a passion, for cats. At first 
she had one or two cats, which attracted 
no attention, of course. But she gradu- 
ally added to that number until she had 
ten or a dozen. And they would follow 
her whenever she would go for a walk; 
they liked her and seemed to understand 
her. Some unkind friend or neighbor of 
hers said that all her felines were tom- 
cats; whether that was so I have no 
means of knowing. But the cats an- 
noyed nobody-she saw to that-and so 
it should have been nobody's business. 
But the mob likes to have something to 
sneer at, to make fun of. To me it is 
simply pathetic. It is pathetic that a 
woman who could give so much love to 
children should have to waste all her 
emotion on cats. But this is the world 
we live in. However, it will not always 
be so. 
156 CHAPTER XLII 
QUESTIONS AND ANSWERS 
During the course of lectures which I 
delivered to women, no subject seemed 
to be of deeper interest, of greater con- 
cern to the audience than the subject of 
the menopause. And the audience did 
not by any means consist of middle-aged 
women exclusively. During the ques- 
tion hour following the lecture, there 
would sometimes be thirty or forty ques- 
tions relating to the menopause even 
when the lecture itself dealt with en- 
tirely different topics. 
I have collected the most important 
of these questions which seemed to be 
of particular concern to the women un- 
dergoing the menopause, and am answer- 
ing them here in a separate chapter, 
though the subjects would practically 
all be found discussed and covered in 
previous chapters. 
Q. Is it true, as Kisch claims, that 
157 QUESTIONS AND ANSWERS 
the menopause ends the sexual life of 
woman? 
A. No, it is not true. Whether 
Kisch really meant to convey that im- 
pression, or whether it was simply an un- 
fortunate use of language, the statement 
and similar statements are not true, and 
are responsible for a good deal of mis- 
understanding. Kisch defines the meno- 
pause as ''that time in a woman's life at 
which her sexual activities come to their 
natural termination marked by the cessa- 
tion of the menses." He further says: 
"the termination of sexual activity has 
arrived and sexual death has taken 
place." The great error consists of 
confusing "sexual" with "reproductive." 
If instead of the word sexual he had used 
the word reproductive, or child-bearing, 
the statement would have been correct. 
And it is necessary to emphasize or re- 
emphasize that reproductive or child- 
bearing is not synonymous with sexual; 
just as a young woman may be sterile 
and still manifest strong sexual activity, 
so a woman after the menopause may be 
158 QUESTIONS AND ANSWERS 
as sexual as a woman before the meno- 
paue. 
Q. Is it true that the menopause 
brings on cancer? 
A. This question has been answered 
in the text of the book. No, it is not 
true. The reason more cancer is found 
during and after the menopause than be- 
fore is because cancer is a disease of old 
age and naturally there is more in mid- 
dle-aged and in old women than in young 
ones. But the menopause has nothing to 
do with bringing about cancer. 
Q. Is it normal for a woman to men- 
struate after 50? 
A. There is nothing abnormal in it. 
While the majority cease to menstruate 
at the age of 48 to 49, still there are many 
women who menstruate up to the age of 
52, 53, 54 and even 56. 
Q. Should a woman of 57 do any- 
thing if she keeps on menstruating? 
A. If her menses are regular, not 
too excessive or not in the form of hem- 
orrhages, nothing whatever should be 
done. It shows that the ovaries are still 
159 QUESTIONS AND ANSWERS 
active, and certainly nothing should be 
done to stop their activity. But if the 
hemorrhages are too severe, or irregular, 
then the woman should have herself ex- 
amined to see if there is not some uterine 
trouble. 
Q. Can the menses come back after 
they have once stopped? 
A. This does occur in a very small 
percentage of cases. It generally means, 
however, that the menopause had not yet 
been fully established. A woman may 
certainly miss her menses for six months 
and then if they would come back, there 
would be nothing abnormal in that. 
There are, however, a few cases on rec- 
ord in which the menopause had been 
suspended for two years or more, and 
then came back and lasted for another 
year or two. 
Q. Can a woman become pregnant 
after the menopause? 
A. There are a few such cases on 
record, but they are so few and far be- 
tween that they need not be taken into 
account. As a rule, it may be stated 
160 QUESTIONS AND ANSWERS 
definitely that with the establishment of 
the menopause the child-bearing period 
is over. 
Q. Is it true that when a woman 
ceases to menstruate she may begin to 
bleed from other parts of the body? 
A. A few such cases have been re- 
ported. This is the so-called vicarious 
menstruation. There are such cases 
among girls and women who while ceas- 
ing to menstruate from the uterus may 
menstruate from the nose or some other 
part of the body. But such cases are 
very rare and need not bother you. 
Every case of so-called vicarious men- 
struation should be carefully examined. 
For instance, there was a case reported 
where the woman, after the establish- 
ment of the menopause, began to pass 
blood from the stomach. And as the 
bleeding was more or less periodical, 
occurring about once in three or four 
weeks, it was taken to be a form of vi- 
carious menstruation. Further develop- 
ment of the case, however, showed that 
the woman had an ulcer of the stomach 
161 QUESTIONS AND ANSWERS 
which had nothing to do with her meno- 
pause. 
Q. Does the removal of one ovary 
bring about the menopause? 
A. No, the cutting out of one ovary 
does not seem to have any influence on 
the time of the menopause. There are 
many women who have had one ovary re- 
moved, and their menstrual and sexual 
life is the same as is that of women who 
had no such operation. 
Q. Does the removal of both ovaries 
bring about the menopause? 
A. Yes, as a general thing. It only 
very, very rarely happens that a woman 
may menstruate some time after the re- 
moval of both ovaries. When this oc- 
curs, there is always a suspicion that a 
small amount of ovarian tissue has been 
removed. 
Q. Does the removal of both ovaries 
always abolish the sexual desire? 
A. Not always. In the vast major- 
ity of cases, yes. But in a number of 
cases the libido remains for a longer or 
shorter period. There are some cases 
162 QUESTIONS AND ANSWERS 
reported where there was even an ex- 
aggeration of the libido. 
Q. Do all women become fat during 
the menopause? 
A. There is a relationship between 
the menopause and obesity. This is 
probably due to a hypo-function or dys- 
function of the thyriod. The thyroid is 
closely connected with the ovaries, and 
during the menopause when the ovaries 
undergo involution, the thyroid may be 
sympathetically involved. Some women 
become enormously fat so that they lose 
every outline of neck and figure. But 
other women are not influenced in this 
respect, while still others actually lose 
even the fat that they have and become 
skinny and angular. This is generally 
the case with women who have had no 
sexual life. 
Q. Can the menopause come on sud- 
denly from a fright or shock? 
A. Yes, it can. A number of cases 
are known where a sudden fright, sud- 
den news of the death of a beloved child, 
has caused the menses to cease either 
163 QUESTIONS AND ANSWERS 
temporarily for several months, or per- 
manently. Worry may also cause the 
menopause. During the war a great 
many women who had sons at the front 
ceased to menstruate. 
Q. What is the general length of a 
woman's sexual life? 
A. That question cannot be answered 
because it is hard to know just when a 
woman's sexual life begins and particu- 
larly when it ends. Older women are 
rather shy in this respect and do not like 
to confess the possession of sexual feel- 
ings. Where men boast of their sexual 
desires, women will deny them. If the 
question should be, "What is the general 
length of woman's reproductive or child- 
bearing period?" the answer would be- 
About 35 years. For the girl becomes 
nubile at the age of 13, and the meno- 
pause usually comes on about the age 
of 48. So 30 to 35 years would be the 
correct answer. As a woman can give 
birth to a child every year, we see how 
many children a woman could have dur- 
ing her reproductive period, if some 
164 QUESTIONS AND ANSWERS 
form of birth control were not employed. 
Q. Does the menopause cause heart 
disease? My mother and two aunts all 
got heart disease during their change 
of life. 
A. No, the menopause does not cause 
heart disease. If there are more cases 
of heart disease during the menopause 
than during any other period, which is 
not at all certain, it is due to the fact 
that heart disease is more likely to de- 
velop in older than in younger people. 
If the three sisters all developed heart 
disease during the menopause period, it 
may have been of hereditary character. 
Certain hereditary lesions develop dur- 
ing the same period. And besides, I am 
not at all sure that these were really 
cases of heart disease. Functional dis- 
turbances during the menopause, such as 
cardiac palpitation, are common. And 
we now know that in former years phy- 
sicians were too ready to make the diag- 
nosis of heart disease when the affliction 
might have been of a purely functional 
nervous origin. Then, again, we also 
know now that the fear of a certain dis- 
165 ease is apt to bring on the correspond- 
ing symptoms of that disease. The tra- 
dition in the family that heart disease 
is apt to develop during the change of 
life may in itself have been responsible 
for the cardiac symptoms. The same as 
fear of insanity at a certain period of life 
because some members of that family be- 
came insane during that period, is often 
responsible for unbalanced behaviour. 
A proper management of the case and 
the passing of the period without any 
development of real insanity convinces 
the patient that the fear was groundless 
and was the real cause of the symptoms 
that were present. 
Q. What is the best thing for the 
flushes of the menopause? 
A. The best thing is atropine sul- 
phate in doses of i/ioo of a grain; but 
this is a powerful drug and should not 
be taken except under a physician's di- 
rections. 
Q. Is thyroid good for obesity? 
A. Yes, it is good a far as efficiency 
is concerned. With thyroid we can us- 
ually reduce a patient very quickly and 
QUESTIONS AND ANSWERS 
166 QUESTIONS AND ANSWERS 
very decidedly. But it is not a drug 
which should be taken by patients in- 
discriminately. The drug should be 
prescribed by a physician only, and the 
physician should see the patient at least 
once or twice a week. For thyroid is 
apt to cause disturbances of the heart un- 
less taken in small doses under careful 
medical supervision. 
Q. Does the menopause cause high 
blood pressure? 
A. This is not a question that can be 
answered in one word, yes, or no. Some 
women passing through the menopause 
develop high blood pressure. But this 
does not mean that in every case the meno- 
pause is the cause of the high blood pres- 
sure. People after forty-five or fifty are 
more apt to have high blood pressure than 
young people, and so we can say that 
it is the age that is responsible for the 
high blood pressure and not the meno- 
pause. But of course I am not going 
to deny that disturbances of the endoc- 
rine secretions may be responsible in some 
cases for high blood pressure. And then 
again, the worries and anxieties depend- 
167 QUESTIONS AND ANSWERS 
ent upon the menopause may contribute 
their share. 
Q. How can we know whether the 
high blood pressure is due to the meno- 
pause or to some organic cause? 
A. A careful examination will give 
us the answer in most cases. If the 
woman's heart, arteries and kidneys are 
normal, we may consider the high blood 
pressure as "functional" or due to the 
menopause. 
Q. Can a shock cause a temporary 
or permanent stoppage of the menses? 
A. That it can cause a temporary ces- 
sation of the menses I have mentioned 
a number of times. But now and then 
we have cases where the cessation of the 
menses is permanent. Dr. Leith Napier 
mentions the case of a woman, aged 30, 
who saw her husband fall dead at her 
feet. She was at the time nursing her 
child, had been nursing it for sixteen 
months; but her periods never returned. 
That woman was living and in good 
health at the age of 71. In a case like 
this we cannot help believing that it was 
the nervous shock that caused the ces- 
168 QUESTIONS AND ANSWERS 
sation of the menses. He also relates the 
case of a woman of 30 who had been 
quite regular in her menses. One day 
she threw a dead rat on the fire, thinking 
it was a piece of coal. She retched for 
hours, and for four years there was no 
return of the menses. After that there 
was an occasional flow, at irregular inter- 
vals. 
Q. What is the difference between 
objective and subjective vertigo? 
A. Objective vertigo is the sensation 
we have of the objects in the room 
moving around us; while subjective 
vertigo is the sensation as if we were mov- 
ing around the objects. 
Q. Can vertigo be caused by high 
blood pressure? 
A. Yes, very often vertigo is caused 
by high blood pressure. 
Q. How high can blood pressure go 
and the person live? 
A. We do not like to see cases of 
blood pressure above 250; but the blood 
pressure may go up as high as 275, or 
even higher, and the person may recover. 
Q. Is it true that some women during 
169: QUESTIONS AND ANSWERS 
the menopause get the mumps? 
A. There are cases of the parotid 
gland swelling up during the menopause. 
It can hardly however be called a genu- 
ine parotitis or mumps. In some cases 
the swelling of the glands occurs periodi- 
cally every month or two. The submax- 
illary glands also swell up. 
Q. What is the best treatment for 
high blood pressure? 
A. The best thing is taking things 
easy, resting in the afternoon for two or 
three hours, avoiding excitement of all 
sorts, giving up playing bridge, leaving 
off coffee and meat, taking daily luke- 
warm baths, an occasional dose of castor 
oil once or twice a week, and mild anti- 
spasmodics, such as bromural, brovalol 
and benzyl benzoate. In very severe 
cases venesection or blood-letting may be 
necessary. 
Q. Is wet-cupping good for the hot 
flushes? A doctor recommended it to 
one of my aunts. 
A. Yes, this measure may be recom- 
mended; drawing off three or four 
ounces of blood may prove decidedly 
170 EPILOGUE 
beneficial. It is also possible that the 
effect of the cupping is not altogether 
physical, but also partly psychic. 
Q. What is the dose of corpus luteum? 
A. The average dose is five to ten 
grains of the dried extract three times 
a day. Subcutaneously, fifteen minims 
may be injected every second or third 
day. 
Q. Is corpus luteum good for the 
hot flushes? 
A. It may be tried. Good results are 
claimed for it, but its value has not yet 
been definitely established. I prefer 
small doses of atropine. 
EPILOGUE 
I have not denied that the menopause 
may give rise to real symptoms, to an- 
noying, serious and, now and then, even 
dangerous disorders. And yet I cannot 
conclude without making another final 
attempt to impress upon the reader my 
conviction that many of the symptoms 
i7i EPILOGUE 
are man-made (or rather woman-made), 
that a large percentage of the disorders 
of the menopause are not inevitable, but 
are due to wrong ideas, to wrong living, 
to wrong social and economic condi- 
tions, and, perhaps most important of 
all, to a wrong, inadequate sexual life. 
When our women, and men too, reach 
that stage in evolution when they can 
live a truly normal life, a life that is 
physiologically and psychologically 
right and adequate, then "the symptoms 
of the menopause" will become a vague 
memory of the past, and "the dangers of 
the climacteric" will be thought of with 
a smile. 
And even now a sane, courageous and 
serene attitude toward the approaching 
change of life will go far in preventing 
some of its unpleasant symptoms and in 
softening, soothing and mitigating those 
of its features which cannot be pre- 
vented. Courage and hopefulness are 
invaluable assets in all conditions o' 
life. 
172 INDEX INDEX 
Abnormal libido, cases 
of 127, 128 
Abortion and prema- 
ture menopause .. 45 
Abortion and preven- 
cep lives 44 
Accidental causes of 
menopause 44 
Adalin 69 
Anal itching, supposi- 
tories for 90 
Anatomical changes of 
menopause 42 
Antipyretics in head- 
ache . 34 
Artificial menopause. 45 
Atresia vaginae 39 
Atropine sulphate .. 65 
Atropine sulphate and 
Flushes 65, 166 
Bad breath, causes of 98 
Bad breath, prescrip- 
tions for 99, 100 
Baths in obesity .... 77 
Bladder, irritability of 35 
Borax in obesity .... 79 
Borborygmi 84 
Brain center controll- 
ing libido 53 
Breast, cancer of .... 64 
Breast, tumors of ... 64 
Breasts, changes in .. 39 
Bringing back menses 46 
Cancer 62 
Cancer, a disease of 
old age 159 
Cancer and the meno- 
pause . 64 
Cancer, lacerated cer- 
vix possible cause of 63 
Cancer, nature of ... 63 
Cancer and the meno- 
pause 64 
Cancer of uterus 63, 114 
Cathartics as cause of 
piles 103 
Cathartics in constipa- 
tion 80 
Cervix, cancerous con- 
dition of 88 
Cervix, disappearance 
of 38 
Cervix, erosion of .. 74 
Change of life in man 54 
Chloral 70 
Classic symptoms of 
menopause 29 
Cleanliness of geni- 
talia 64 
Climacteric, male ... 54 
Climacteric 22 
Climacterium 22 
Coffee and constipa- 
tion 81 
Coitus, enjoyment of 53 
Coitus, serenity after 72 
Congestion due to fre- 
quent coitus 73 
Constipation 80 
Constipation and the 
menopause 32 
Corpus luteum .. 65, 171 
175 INDEX 
Corpus luteum, dosage 
of 171 
Corpus luteum and hot 
flushes 171 
Crow's feet 40 
Depression during 
menopause 32 
Dermatoses 35 
Desire to be alone dur- 
ing menopause ... 155 
Diabetes and itching 
of vulva 92 
Diet in constipation. 80 
Dodging years 22 
Drugs in insomnia.. 69 
Eczema of vulva ... 93 
Eczema of vulva, oint- 
ment for 93, 94 
Elopement and meno- 
pause 130 
Emotion wasted on 
cats during meno- 
pause 156 
Endocrine glands, im- 
portance of 27 
Enemas for constipa- 
tion 82 
Epilepsy and oophor- 
ectomy 46 
Erosion of cervix .. 74 
Eroticism in man ..., 55 
Exercise in obesity.. 79 
Fainting spells 33 
Fainting, treatment of 66 
Fallopian tubes 52 
Fallopian tubes, shrink- 
age of 38 
False pregnancy ..., 60 
Fat on abdomen .... 61 
Fear and Heart Dis- 
ease 166 
Fear and Insanity ... 166 
Fear of insomnia .... 68 
Fear of menopause, 26, 36 
Fear of pregnancy.. 139 
Fear of pregnancy and 
libido 53 
Fibroid tumors and 
oophorectomy 46 
Flushes and wet-cup- 
ping 170 
Flatulence during the 
menopause 32 
Flushes 65, 111 
Fortunate couples ... 58 
Free sexual life, long- 
ing for 129 
Frequency of flushes 29 
Fright and menopause 163 
Frigidity and preven- 
ceptives 49 
Frigidity, due to fear 
of pregnancy ...... 48 
Gas in bowels 61 
Glandular preparations 65 
Glycerin tampons for 
congestion 75 
Gonorrheal inflamma- 
tion of Fallopian 
tubes 52 
Hair, changes in .... 40 
Hair, endocrine prepa- 
rations for loss of 102 
176 INDEX 
Hair, loss of 101 
Hair, lotion for loss of 101 
Headache 34 
Headaches in meno- 
pause Ill 
Heart disease and fear 166 
Heart disease and men- 
opause 165 
Hemorrhage, uterine 62 
Hemorrhages ... 159, 160 
Hemorrhoids 103 
Hemorrhoids, applica- 
tion for external.. 104 
Hemorrhoids, o i n t- 
ment for itching.. 104 
Hemorrhoids, supposi- 
tories for 105 
High blood pressure 
and menopause .... 167 
High blood pressure, 
best treatment for.. 170 
High blood pressure, 
menopause, and or- 
ganic cause 167 
High blood pressure 
and vertigo 169 
Homosexuality, emo- 
tional 137, 138 
Homosexuality and 
the menopause .... 137 
Husband, normal sex- 
ual decay in 135 
Hygienic measures .. 66 
Hygienic measures in 
insomnia 68 
Hypnotics in insom- 
nia 70 
Hysteria and oophor- 
ectomy 45 
Imaginary lovers 150, 151 
Impotence and infidel- 
ity 136 
Impotence in intellec- 
tual men 136 
Increased libido, psy- 
chic origin in old 
maids 49 
Indigestion during 
menopause 32 
Inflammatory condi- 
tions and libido ... 50 
Insanity and fear ... 166 
Insanity and imagin- 
ary pregnancy 61 
Insanity and oophor- 
ectomy 46 
Insanity at menopause 114 
Insomnia and ungrati- 
fied libido 70 
Insomnia, drugs in .. 69 
Insomnia during meno- 
pause 68, 152 
Insomnia, hygienic 
measures in 68 
Intellectual occupation 43 
Intensified libido .... 51 
Irritability 55, 56 
Itching, mild, formula 
for 88 
Jealousy 55, 57 
Jealousy of innocent 
husband 133 
Kleptomania during 
climacteric 145 
177 INDEX 
Labor, severe, and pre- 
mature menopause. 45 
Leucorrhea, alum tam- 
pon for 95 
Leucorrhea and an- 
emia 95 
Leucorrhea and ecze- 
ma of vulva 93 
Leucorrhea, douches 
for 96 
Leucorrhea, hygienic 
measures for 95 
Leucorrhea in meno- 
pause 64, 112 
Leucorrheal discharge 
causing itching .... 88 
Libidinous tumescence 91 
Libido, abnormal .... 74 
Libido and removal of 
ovaries 162 
Libido controlled by 
brain center 53 
Libido, diminished .. 47 
Libido, diminshed dur- 
ng menopause .... 32 
Libido exaggerated dur- 
ing menopause,.. 32 47 
genuine .... 72 
Libido, intensified ... 141 
Libido, intensified and 
physical suffering.. 58 
Libido, intensified by 
jealousy 134 
Libido, normal 73 
Libido, pathological.. 73 
Libido, restraint of.. 48 
Libido, spurious ...... 72 
Libido, extinguish- 
ment of 58 
Libido, intensification 
of 58 
Libido, ungratified and 
insomnia 70 
Lubricants in consti- 
pation 83 
Luminal 69 
Man's change of life 
and increased libido 57 
Man's libido during cli- 
macteric 55 
Massage in obesity .. 78 
Masturbation during 
menopause, 124, 125, 126 
Melancholia, m e n o- 
pause etioligic, fac- 
tor in,... 142, 143, 144 
Menopause, age of ap- 
pearance of 23 
Menopause, derivation 
of word s 22 
Menopause, earliest 
case of 25 
Menopause, injurious 
errors concerning .. 21 
Menopause, latest case 
of 25 
Menopause, sexual de- 
sire after 18 
Menopause, terms for 22 
Menorrhagia 31 
Menses, stoppage of, 
and shock .... 45, 163 
Menstruation, re-estab- 
lishment of 160 
178 INDEX 
Menstruation, vicari- 
ous 161 
Metrorrhagia 31 
Migraine 152 
Migraine during meno- 
pause Ill 
Migraine, remedies for 152 
Mind, power of over 
body 136 
Mons Veneris 39 
Moral code of ultra- 
radicals 56 
Mumps and menopause 170 
Normal age of meno- 
pause 25 
Normal sudden meno- 
pause 44 
Nosebleed 34 
Nosebleed, treatment 
of 66 
Numbness of limbs .. 34 
Nymphomania 74 
Obesity 76 
Obesity, foods in treat- 
ment of 76 
Obesity and m e n o- 
pause 163 
Obesity and thyroid.. 166 
Old age and cancer .. 62 
Oophorectomy 45 
Operation for cancer 63 
Ovarian hormones, in- 
crease in 50 
Ovaries, complete re- 
moval of 46 
Ovaries, mal-develop- 
ment of 47 
Ovary, atrophy of .. 28 
Ovary, disturbance in 
function of 28 
Ovary, removal of, 
and menopause .... 162 
Ovaries, removal of, 
and sexual desire.. 162 
Ovaries, shrinkage of 38 
Ovaries, surgical re- 
moval of 52 
Pain due to cancer .. 62 
Pain following coitus 52 
Palpitation of the heart 
Passees women 42 
Persecution of men 
during menopause, 
146, 148, 149, 150 
Perspiration of feet, 
offensive 106 
Perspiration of feet, 
treatment of .. 106, 107 
Phantom pregnancy.. 61 
Pituitary, hypo-func- 
tion of 33 
Pregnancy after men- 
opause 160 
Pregnancy, frequent 
and menopause .... 24 
Pruritus 34 
Pruritus of sexual char- 
acter 91 
Psychic troubles due 
to husband 54 
Puberty 38 
Recrudescence of de- 
sire 49 
Restlessness, case of. 139 
Rumbling in bowels.. 84 
179 Rumbling in bowels 
due to cathartics .. 85 
Rumbling in bowels, 
prescription for, 84, 85 
Rumbling in; bowels, 
turpentine stupe for 85 
Sea bathing in obesity 78 
Serenity and chosen 
work 120 
Sexology in colleges.. 19 
Sexual libido 47 
Sex rleations, frequent 
during menopause.. 73 
"Sexual" and "repro- 
ductive," meaning of 
Sexual aversion 121 
Sexual end at meno- 
pause 122, 123 
Sexual life of woman, 
length of 164 
Shock and stoppage 
of menses 
Shock, cessation of 
menses due to ... 45 
Skin, roughening of .. 40 
Spurious libido, 50 
Spurious pregnancy.. 60 
Sudden onset of meno- 
pause 44 
Suicide during meno- 
pause 153 
Sulphonal 70 
Surgical menopause.. 51 
Tact, wife's 59 
Thyroid 46, 65 
INDEX 
Thyroid gland, disturb- 
ance of 27 
Thyroid in obesity, 79, 166 
Tingling in limbs ... 34 
Trional 70 
Truth in regard to 
menopause 37 
Tumors of breast ... 64 
Vagina, changes in .. 38 
Vagina, narrowing of 39 
Vagina, scratching with 
foreign objects .... 87 
Vaginal discharge, 
treatment of 89 
Valerian preparations 65 
Veronal 69 
Vertigo 33 
Vertigo and high blood 
pressure 169 
Vertigo, objective and 
subjective 169 
Vicarioujs menstrua- 
tion 34 
Vulva, congested .... 87 
Vulva, neurotic itch- 
ing of 88 
Vulva, severe itching 
of 86 
Vulva, shrinkage of.. 39 
Uterus, shrinkage of.. 38 
flushes 170 
Wet-cupping and hot 
Worry and m e n fl- 
pause 164 
Wrinkles 40 
180 THE PUBLICATIONS OF THE 
CRITIC AND GUIDE CO. 
12 Mt. Morris Park W., New York City 
In presenting a brief description of the 
books which we publish we do so in the 
firm conviction that each book mentioned in 
this catalogue fills a niche of its own, stands 
for something distinct and definite. There 
is not one rehash book among them; not 
one of them is a compilation of platitudinous 
commonplaces; each book is truly original, 
either in its subject matter or in the manner 
of presentation. And each book will give 
the reader valuable information or at least 
precious food for thought. It is admitted 
that as thought-stimulants our books have 
no equals. Each book is either the only 
one of its kind or the best of its kind. The 
fact that without practically any advertis- 
ing, and without any salesmen in the field, 
our books have gone through many editions 
is some proof of their intrinsic value. 
Please peruse the following pages care- 
fully, and see if they do not contain some 
books which you need. Send remittance 
with order and the books will be dispatched 
to you at once. We prepay postage or 
expressage. NEVER-TOLD TALES 
GRAPHIC STORIES OF THE DISASTROUS RESULTS 
OF SEXUAL IGNORANCE 
By WILLIAM J. ROBINSON, M.D. 
Dr. Robinson was among the pioneers in this country to 
preach and demand sexual enlightenment for the masses. At 
a time when to discuss sexual subjects even at medical meet- 
ings was considered improper and undignified, when to give 
to the laity information on the physiology and pathology of 
sex was considered almost criminal, Dr. Robinson did both. 
It was largely due to his influence that the silence which 
for centuries surrounded all sexual subjects like a thick, im- 
penetrable shroud was finally broken; and the people began 
to learn the truth which concerned not only their health but 
their very life. 
The tragedies he witnessed he crystallized in his now 
famous NEVER-TOLD TALES, which was the first book 
in the English language to present in the form of short 
stories the disastrous results of sexual ignorance, of sexual 
disorders, of too many children among the poor, etc. 
Price, $1.50 
STORIES OF LOVE AND LIFE 
A companion volume to Never Told Tales. Some of the 
stories it contains are of incomparable beauty and importance. 
Price, $1.50 
A CLERGYMAN'S SON AND DAUGHTER 
A unique novel, dealing with the mooted question of 
hereditary transmission, with the War, and some other im- 
portant problems. 
Price, $2.00 
When the above three books are ordered at the same 
time, the price for the three is $4.00 instead of $5.00. 
THE CRITIC AND GUIDE, 12 Mt. Morris Park W., New York City Square, Sane and Honest 
In the first chapter of "Woman: Her Sex and Love Life," Dr. 
Robinson says: "The task I have put before myself in this book is 
to give our girls and women sane, square and honest information 
about their sex organs and sex nature, information absolutely free 
from luridness, on the one hand, and maudlin sentimentality on the 
other." 
And his concluding words are: "I trust that 'Woman: Her Sex 
and Love Life' will help, in some slight degree, in spreading healthy, 
sane and honest ideas about sex among the men and women of 
America." 
In working out this aim, Dr. Robinson is wholly practical. His 
purpose is to assist women in the comprehension and development 
of their sexual life. 
Woman, Her Sex and Love Just Fey of the 
By Chapters 
Life DR. WILLIAM J. ROBINSON Fenmte Sex Organs 
-deals fully with the larger aspects of the Puberty 
subject, but equally with the "small things" rrhe*Hygiene of Menstrua- 
that often make or break love and life. Pregnancy 
The book isn't simply a treatise on the Disorders of Pregnancy 
structure of the sex organs; it is instinct 
with an inspiring philosophy of love and life. Abortion and Miscarriage 
It is a complete book, by a physician Menopause or Change of 
with a wholly human outlook, an exponent Masturbation 
of the humanized science of our day. Venereal Diseases 
Women, even more than men, require Vulvovaginitis in Little 
the fullest information about sex. Igno- Venereal Prophylaxis 
rance in matter sexual is more disastrous Alcohol, Sex and Venereal 
to women than to men. w?? and Who May 
The simple practical points in this book Not Marry 
would render millions of homes happier; ®irt.h .Control 
prevent the disruption of many a family; sterility**118 
and show how to preserve love and sexual The Hymen 
attraction. Frigidity in Women 
T1, , ... , Single Standard of Sexual 
It destroys many injurious errors, and Morility 
teaches truths that have never been pre- national Divorce System 
sented in a book before. V j 
... . Advice to the Married and 
The delicacy of the book is charming; Those About to Be 
the presentation free from either grossness Difference Between the Sex 
nr nrnderv and Love Llfe o£ Mau 
or prudery. and Woman 
PRICE, $3.00 Postpaid Jealousy and How to Com- 
_ bat It, etc., etc. 
SEX KNOWLEDGE FOR GIRLS AND WOMEN 
Or What Every Girl and Woman Should Know 
Illustrated 
Condensed from the Author's "Woman: Her Sex & Love Life" 
Price, $1.50 
THE CRITIC AND GUIDE, 12 Mt. Morris Park W., Naw York City SEXUAL PROBLEMS 
OF TODAY 
By WILLIAM J. ROBINSON, M.D. 
nnniimtiiiHniiiuttiniiiuHiuiHiiiiiiiwHiiiiuinniiiiiiiuiiiitniiiniiiiiniiiiuininiiiHrrmimniiiiiuniiuiiiinnninniiiminnniinrninniiiminiiniiiiiinninnrannnnnnnnnninnB 
Dr. Robinson's work deals with many phases of 
the sex question, both in their individual and social 
aspects. In this book the scientific knowledge of a 
physician, eminent as a specialist in everything per- 
taining to the physiological and medical side of these 
topics, is combined with the vigorous social views 
of a thinker who has radical ideas and i§ not afraid 
to give them outspoken expression. 
A few of the subjects which the author discusses 
in trenchant fashion are: 
The Relations Between the Sexes and Man's Inhumanity 
to Woman.-The Influence of Abstinence on Man's Sexual 
Health and Sexual Power.-The Double Standard of Morality 
and the Effect of Continence on Each Sex.'-The Limitation of 
Offspring: the Most Important Immediate Step for the Better- 
ment of the Human Race, from an Economic and Eugenic 
Standpoint.-What To Do With the Prostitute and How To 
Abolish Venereal Disease.-The Question of Abortion Considered 
In Its Ethical and Social Aspects.-Torturing the Wife When 
the Husband Is At Fault.-Influence of the Prostate on Man's 
Mental Condition.-The Most Efficient Venereal Prophylactics, 
etc., etc. 
"SEXUAL PROBLEMS OF TODAY" will give 
most of its readers information they never possessed 
before and ideas they never had before-or if they 
had, never heard them publicly expressed before. 
Cloth-bound, 340 Pages, $2 Postpaid 
THE CRITIC AND GUIDE CO. 
12 MT. MORRIS PARK W.. NEW YORK MARRIED LIFE 
AND HAPPINESS 
OR 
LOVE AND COMFORT IN MARRIAGE 
To Promote Harmony in Married Life, to Avoid Avoidable Friction, 
to Remove Removable Causes of Discord, to Help Strengthen 
and Make Permanent the Foundation of Love is 
the Purpose of this Book 
BY 
WILLIAM J. ROBINSON, PH.G., M.D. 
Chief of the Department of Genito-Urinary Diseases and Dermatology, Bronx 
Hospital and Dispensary; Editor of The Critic and Guide; Author of: Treat- 
ment of Sexual Impotence and Other Sexual Disorders in Men and Women; 
Treatment of Gonorrhea; Woman, Her Sex and Love Life; Sexual Prob- 
lems of To-day; Sex Knowledge for Men and Boys; Birth Control or 
the Limitation of Offspring; Never Told Tales; Stories of Love and 
Life; Eugenics and Marriage; Sex Knowledge for Women and 
Girls; Sex-Morality-Past, Present and Future; Sexual Truths; 
Prescription Incompatibilities, etc.; Ex-President of the Berlin 
Anglo-American Medical Society, Fellow of the New York 
Academy of Medicine; Fellow of the American Medical 
Association; Member of the New York State Medical 
Society, Medical Society of the County of New 
York, Harlem Medical Association, American 
Medical Editors' Association, American Uro- 
logical Association, Internationale Gesellschaft 
fiir Sexualforschung, British Society for 
the Study of Sex Psychology, American 
Association for the Advancement of 
Science, etc., etc. 
Price, $3.00. 
THE CRITIC AND GUIDE COMPANY 
12 MT. MORRIS PARK W. NEW YORK CITY I consider myself extremely fortunate in having been instru- 
mental in making this remarkable book accessible to the English 
reading public. It is a great book well worth a careful perusal. 
From Dr.jWilliam J. Robinson's Introduction. 
The Sexual Crisis 
A CRITIQUE OF OUR SEX LIFE 
A Psychologic and Sociologic Study 
By GRETE M EISEL-H ESS 
AUTHORIZED TRANSLATION BY EDEN AND CEDAR PAUL 
EDITED, WITH AN INTRODUCTION 
By WILLIAM J. ROBINSON, M. D. 
One of the greatest of all books on the sex question 
that have appeared in the Twentieth Century. 
It is a book that no educated man or woman, lay or 
professional, interested in sexual ethics, in our marriage 
system, in free motherhood, in trial marriages, in the 
question of sexual abstinence, etc., etc., can afford to 
leave unread. Nobody who discusses, writes or lectures 
on any phases of the sex question, has a right to overlook 
this remarkable volume. Written with a wonderfully 
keen analysis of the conditions which are bringing about 
a sexual crisis, the book abounds in gems of thought and 
in pearls of style on every page. It must be read to be 
appreciated. 
A Complete Synopsis of Contents Will Be Sent on Request 
350 PAGES. PRICE $3.00 
CRITIC AND GUIDE CO. 
02 MT. MORRIS PARK W NEW YORK CITY Eleventh Edition-Just Off the Press 
SEXUAL IMPOTENCE 
A Practical Treatise on the Causes, Symptoms and Treatment 
of Sexual Impotence and Other Sexual Disorders 
in Men and Women 
By WILLIAM J. ROBINSON, M.D. 
Chief of the Department of Genito-Urinary Diseases and Derma- 
tology, Bronx Hospital and Dispensary; Editor of "The Critic and 
Guide"; Editor of "The Journal of Sexology"; Author of "The Treat- 
ment of Gonorrhea", "Woman: Her Sex and Love Life", etc.; Fellow 
of the New York Academy of Medicine; Member of the American 
Urological Association, etc. 
Eleventh Edition, revised and enlarged, 502 pages. 
Illustrated. Price, $5.00. 
The eleventh edition has just come off the press. Dr. 
Robinson has taken advantage of the opportunity to subject 
the entire book to a thorough revision, and has added a num- 
ber of chapters dealing with gland transplantation, endo- 
crinology, the Steinach operation, and containing additional 
case reports, comments and explanations. 
Those who know the book consider it the best of its kind 
in any language. Its outstanding features are its "practical- 
ness", and its bright, easy, vivacious style. Every chapter 
is full of practical points, of easily applicable advice; it is 
entirely free from any fads and mysterious methods of treat- 
ment, any hints at hocus-pocus. It is a sane, rational, com- 
mon-sense book. Every physician who will make a study 
of this book will become a better physician in general, and 
will certainly be able to treat his sexual cases with better 
success. 
THE CRITIC AND GUIDE, 12 Mt. Morris Park W., New York City At last vze have a clear, plain, concise book on the treat- 
ment of Gonorrhea and its various complications, written 
expressly for the general practitioner. 
No Physician who has occasion to treat Gonorrhea can do justice to his 
Patient without a study of this latest and clearest volume on the subject. 
THE TREATMENT OF 
GONORRHEA 
And Its Complications in Men and Women. 
For the General Practitioner. 
By 
' WILLIAM J. ROBINSON, 
M.D. 
An idea of the scope of this work may be gained from the Chapter Headings; 
I. Extent and Seriousness of Gonorrhea. 2. Classification of Urethra* 
Inflammations. 3. Gonorrheal Urethritis in the Male. 4. The Germ and the 
Diagnosis of Gonorrhea. 5. Course and Symptomatology of Acute Gonorrhea. 
6. Treatment of Acute Gonorrhea. 7. Case Reports. 8. Common Bacterial Ure- 
thritis. 9. Chancroidal Urethritis. 10. Syphilitic Urethritis. 11. Chemical 
Urethritis. 12. Prophylactic Urethritis. 13. Traumatic Urethritis. 14. Toxic 
Urethritis. 15. Urethritis from Excess and Masturbation. 16. The Widely Vary- 
ing Conditions Known as Chronic Gonorrhea. 17. Treatment of Chronic Gonor- 
rhea. 18. Length of Time Required to Cure Chronic Gonorrheal Conditions. 19. 
Instruments Used in Treatment. 20. Abortive Treatment. 21. Prevention of 
Gonorrhea. 22. Minor Complications of Gonorrhea (Phimosis, Paraphimosis, 
Balanitis, Adenitis, Painful Erections and Chordee, Retention of Urino). 23. Acute 
Prostatitis. 24. Chronic Prostatitis. 25. Epididymitis. 26. Seminal Vesiculitis. 
27. Gonorrhea of the Rectum. 28. Gonorrhea of the Mouth. 29. Stricture. 
30. Gonorrheal Rheumatism. 31. Gonorrhea vs. Tobacco, Alcohol and Sexual 
Intercourse. 32. Gonorrhea in Women. 33. Vulvovaginitis in Little Girls. 34. 
Gonorrheal Ophthalmia. 35. Minor Points. Part II.-Materia Medica of Gonor- 
rheal and Non-Gonorrheal Urethritis and Their Complications. 36. Silver Salts 
-Inorganic and Organic. 37. Miscellaneous Antiseptics and Astringents. 38. 
Vegetable Astringents. 39. Local Anesthetics. 40. Anti-Gonorrheal Remedies 
for Internal Use. 41. Urinary Antiseptics. 42. Lubricants. 43. Formulary. 
315 pages, cloth, $3.00 postpaid 
THE CRITIC AND GUIDE COMPANY 
12 MT. MORRIS PARK W. NEW YORK CITY We believe it is the only book of its kind in the English language. 
It is the book you have been waiting for. 
SEX KNOWLEDGE FOR BOYS AND MEN 
By WILLIAM J. ROBINSON, M.D. 
Illustrated 
An honest, unbiased, truthful, strictly scientific and up- 
to-date book, dealing with the anatomy and physiology of the 
male sex organs, with the venereal diseases and their preven- 
tion, and the manifestations of the sex instinct in boys and 
men. 
Absolutely free from any cant, hypocrisy, falsehood, ex- 
aggeration, compromise, or any attempt to conciliate the 
stupid or ignorant. 
An elementary book written in plain, understandable 
language, which should be in the possession of every adoles- 
cent boy and every parent. 
Dr. Robinson believes that fear should have no place in 
our life, for morality based upon fear is not morality at all, 
only cowardice. He believes there is a better method, and 
that method he uses in his book. 
Dear Doctor Robinson:- 
Thank you for giving us the book for Men and Boys. At last I have a 
book which I can hand to a boy without insulting his intelligence. I have 
tried it out on several boys of various ages and economic status. They are 
almost pitifully grateful and unanimous in their approval. You might be 
interested to know that the boys regard your position on masturbation as 
conservative. In this matter where the boy's experience and observation is so 
widely at variance with what the conventional sex book says, the boy prop- 
erly decides that he is being "strung" and discards the whole book as "bull". 
By sticking to the truth you have held their confidence so that they vote 
you infallible. 
The tone of the book produces an admirable effect and I doubt if it is any 
Tgera.tion to say that you have done more for cleanly sanity in these 
rs than all the preaching and more or less well meant lying of the last 
centuries. You have met the actual requirements and put the boy 
in t. way of honest and sensible thinking. T*he younger generation has no 
way <. expressing its gratitude to you personally, but you may be sure that 
it is none the less genuine. 
Washington, D. C. Sincerely, E. S. SHEPHERD. 
Price, cloth bound, $2.00 
THE CRITIC AND GUIDE, 12 Mt. Morri. Park W.< New York City BIRTH CONTROL 
or 
THE LIMITATION OF 
OFFSPRING 
BY THE PREVENTION OF CONCEPTION 
By WILLIAM J. ROBINSON, M.D. 
With an Introduction by A. Jacobi, M.D., LL.D., ex-President 
of the American Medical Association 
All the arguments for and against the voluntary limita- 
tion of offspring or birth control concentrated in one book 
of 250 pages. 
The Limitation of Offspring is now the burning question 
of the day. It has been made so by Dr. William J. Robin- 
son, who was a pioneer in this country to demand that people 
be permitted to obtain the knowledge how to limit the number 
of their children, how to prevent conception when necessary. 
For many years he fought practically alone; his propaganda 
has made hundreds of thousands of converts-now the ground 
is prepared and the people are ready to listen. 
Written in plain popular language. A book which every- 
body interested in his own welfare and the welfare of the 
race should read. 
Cloth, $2.00 Postpaid 
FROM THE REVIEWERS 
The Medical Council-Fairly discuss- ently by many nations, and will 
Ing his subject from every angle, the doubtless attract attention to a prob- 
author champions the cause of revi- lem in eugenics quite neglected by 
cion of our laws so as to permit American students of sociology, 
means being freely used to prevent 
conception. While many persons will The Providence Medical Journal-Dr. 
disagree with the conclusions, the Robinson is at his best in this propa- 
style is scientific, chaste and philo- ganda for the limitation of offspring, 
sophical. The work is a contribution writing with cool, dispassionate logic 
to a live subject viewed vastly differ- and sincerity. The question is a big, The Book That Has Created Public Opinion on the Impor- 
tant Subject of Birth Control! 
deep one, going to the very roots of plight of the unwillingly pregnant 
the social fabric, and further argu- mother or of the economically tor- 
ments must be adduced to convince tured father, the case for the regula- 
us of its unquestioned merits. . . . tion of conception rests most stably 
However we may feel as to the value on the rights of children. It is inl- 
and righteousness of the movement, it portant that no accidental child shall 
is one which ultimately is for physl- be forced upon parents. It is even 
cians to decide. Dr. Robinson pre- more important that no accidental 
sents his side of the argument clearly parents shall be forced upon a child, 
and the book is well worth reading. The fundamental right of every child 
is its right to be desired, its right to 
St. Paul Medical Journal-Dr. Rob- * friendly environment 
inson frankly favors limitation of off- 
spring and gives his arguments in a ?lear, unvarnished and thoroughgoing 
vigorous and fearless way. He re- Zf'th/™ 
gards the present federal and state and medical implications of the pre- 
laws, which Class contraceptive advice nraoti™ or*3 
with obscence literature, as intoler- tha 
able and urges that every effort be FQ0le?h'?eond^bob2a h * in® 
made to repeal them. Dr. Jacobi sup- 
ports, unreservedly, this contention. tho t?nO>otLeabrhS 
The lay press has been opened to the supp YJZZ 
propaganda and, with or without J'00'* 
medical sanction, the subject is open £ 
to discussion. It seems to the re- pldity have been able to advance, 
viewer that Dr. Robinson's work de- N Y k raii-He begins bv de- 
serves the careful and tolerant atten- scribingYthe uSppSess, fhe deSorll- 
tion of the medical profession. iza.tion, the physical and economic 
disaster which is the common result 
The New Republic-The forces of of enforced unlimited maternity among 
sanctimony and dulness are indiffer- the poor, and demands the abrogation 
ent or unimpressed when science ex- of the laws which make it a crime 
plains that large families mean ex- for any one, even a physician, to give 
hausted mothers, feeble offspring, and information regarding methods of fam- 
a high infant mortality; that igno- ily limitation, even in cases where 
rance of contraception leads husbands such a course is directly indicated by 
to resort to prostitutes and wives to every conclition of health and pru- 
submit to abortion; and that the law dence. He then discusses the ortho- 
forbidding the truth about preven- dox remedies of late marriage or com- 
fives to be told is responsible directly plete abstinence, both from the medi- 
for syphilitic, cretinous, and insane cal and social angle, and takes up in 
children, and indirectly for diseases, detail the many objections which are 
perversions, and crimes without num- offered to the rational limitation of 
ber. offspring by contraception, such as 
Pious, well-meaning people are hot- "The Race Suicide Bugbear,'' the sup- 
rifled at the artificial sterilization of posed immorality, injuriousness or un- 
marriage. But what is the steriliza- reliability of contraception; and a 
tion of marriage compared to the ter- great many others. 
rorization of marriage through the Dr. Robinson's book is the only 
fear of pregnancy? Dr. Robinson's popular work published in this coun- 
wide professional experience leads him try that deals with this subject in a 
to <_ include that ninety marriages out simple, thorough and authoritative 
of a hundred are haunted and hunted manner, and in the campaign to legal- 
by tl e specter of a child that the ize the limitation of offspring it should 
mother doesn't want and the father be widely circulated, and will no 
can't support. Yet, cruel as is the doubt be so with excellent results. 
THE CRITIC AND GUIDE, 12 Mt. Morris Park W., New York City SEXUAL TRUTHS 
VERSUS 
SEXUAL LIES, MISCONCEPTIONS AND 
EXAGGERATIONS 
By WILLIAM J. ROBINSON, M.D. 
This book effectually demolishes the numerous lies and 
senseless exaggerations which dabblers in sexology, either 
through ignorance or design, are offering to the public, and 
which are responsible for so much physical misery and men- 
tal agony. In Dr. Robinson's best vein: clear, concise and 
incisive. With each sledge-hammer blow of his logic a lie is 
demolished, with each turn of the rays of reason a dark place 
is illumined, with each dialectic pull a century-old supersti- 
tion is uprooted. 
Contains several important articles from the pens of the 
world's greatest sexologists. 
Price, $5.00 
SEX MORALITY, PAST, PRESENT AND FUTURE 
A frank and open discussion of sex morality as it was, as 
it is, and most important, as it is likely to be in the near and 
in the distant future.-Price, $2.00. 
STEKEL'S ESSAYS ON SEX AND PSYCHOANALYSIS 
While we are far from agreeing with everything this 
author has written, this book contains some of his most 
interesting, most important and most thought-provoking es- 
says.-Price, $5.00. 
THE CRITIC AND GUIDE, 12 Mt. Morris Park W., New York City SOME OF OUR BOOKS WHICH WE HAVE NO ROOM 
TO DESCRIBE IN DETAIL 
Woman from Bondage to Freedom, by Raley Husted Bell $2.00 
Population and Birth Control: A Symposium-- --- 3.00 
Small or Large Families, by Drysdale and Havelock Ellis-_- 1.50 
Uncontrolled Breeding or Fecundity vs. Civilization-.--- 1.50 
Heredity, Disease and Evolution, by Prof. Ribbert„.---... 2.00 
Some Aspects of Adultery, by Raley Husted BelL.- 2.00 
Pioneers of Birth Control, by Dr. Victor Robinson 1.00 
Jacob Henle, by Dr. Victor Robinson.. - 3.00 
Stekel's Essays on Sex and Psychoanalysis-.-........... 5.00 
The Don Quixote of Psychiatry, by Dr. Victor Robinson 3.00 
The Venereal Peril, by Dr. William L. Holt. -.25 
The Hunter, by Olive Schreiner, with an introduction by Dr. 
Robinson, entitled A Page from My Life „-. .50 
The Menopause: Woman's Critical Age; Its Disorders and Dan- 
gers, and Their Prevention and Treatment. An extremely 
valuable book for all women approaching or passing through 
the Menopause - -.---- 2.00 
JOURNAL OF SEXOLOGY AND 
PSYCHANALYSIS 
Edited by 
William J. Robinson, M.D. and S. A. Tannenbaum, M.D. 
The only journal of its kind in the English or in any 
other language. Indispensable to those interested in all 
phases of sexology, theoretical and practical, and in sane, 
rational psychoanalysis. 
Five Dollars a year in advance; Single Copies $1.00 each 
If you do not wish to miss a single copy of this new, significant 
journal, full of vital matter, send in your subscription NOW. 
THE CRITIC AND GUIDE, 12 Mt. Morri* Park W., New York City A LIST OF OUR PUBLICATIONS 
Treatment of Sexual Impo- *Dr. Stekel's Essays on Sex v 
tence „ ■■ -.$5.00 and Psychoanalysis .....- 5.00 
Treatment of Gonorrhea 3.00 *Sexual Truths 5.00 
Woman: Her Sex and Love Prescription Incompatibilities 3.00 
Life - - 3.00 Population and Birth Con- 
Married Life and Happiness 3.00 troL A Symposium 3.00 
Sexual Problems of Today... 2.00 Tbef Critic a n d Guide 
Monthly, single copies 25 
Sex Knowledge for Men and cents; a year 2.00 
Boys 5.00 journai of Sexology and Psy- 
Birth Control or The Limita- choanalysis, single copies 
tion of Offspring by the one dollar; a year 5.00 
Prevention of Conception 2.00 T , r i A 
Dr. Jacobi s Complete 
Small or Large Families, by Works. 8 vols. Edited by 
Drysdale and Havelock Dr. Robinson 20.00 
Ellis 1.50 uncontro]]ej Breeding, or 
Sex Morality, Past Present Fecundity vs. Civilization, 
and Future 2.00 by Adeline More™ 1.50 
Never Told Tales - 1.50 Sex Morality and Nervous- 
Stories of Love and Life 1.50 ness> bY Prof- Freud 50 
A Clergyman's Son and Objects of Marriage, by 
Daughter 2.00 Havelock Ellis .25 
Eugenics and Marriage 1.50 Married Love, by Lord Daw- 
son .. _ .25 
Sex Knowledge for Women 
and Girls 1.50 Tbe Venereal £en ' by Wm' oe 
L. Holt, M.D .25 
The Sexual Crisis, by Meisel- 
Hess 3.00 The Hunter, by Olive 
Schreiner, with an intro- 
Heredity, Disease and Evolu- duction by Dr. Robinson, 
tion, by Prof. Hugo Ribbert 2.00 entitled, A Page from My 
Woman from Bondage to Life ~ ™ .50 
Freedom, by Dr. Raley Pioneers of Birth Control, by 
Husted Bell 2.00 Dr. Victor Robinson 1.00 
*Some Aspects of Adultery, Jacob Henle, Dr. Victor 
by Dr. Raley Husted Bell 2.00 Robinson 3.00 
(Books marked with * are sold by subscription only to professional 
people and students of sexology.) 
Books not otherwise marked are by Dr. William J. Robinson. 
THE CRITIC AND GUIDE, 12 Mt. Morris Park W., New York City COLLECTANEA JACOBI 
THE COLLECTED WORKS OF 
A. JACOBI, M.D., LL.D. 
Ex-President of the American Medical Association, of the New York 
Academy of Medicine, etc. 
Edited by 
WILLIAM J. ROBINSON, M.D. 
Full of years, rich in honors, of ripe scholarship, 
and still in the active practice of his profession, Dr. 
A. Jacobi entrusted Dr. Robinson with the collecting, 
collating, editing and preparing for publication of his 
papers, articles, essays and addresses. The wonder- 
ful versatility of this remarkable man is clearly evi- 
denced by the wide field of his literary activity as 
physician, teacher, author, sociologist, patriot and 
philosopher. The wealth of his varied experiences, 
and the liberality and catholicity of his views, perme- 
ate all of his articles, essays and addresses. To Dr. 
Robinson, the arrangement, classification and com- 
pilation of the published efforts of this master mind 
has been, indeed, a labor of love and a scientific and 
literary delight. 
Eight (8) volumes. Extra cloth, gilt top, etc. 
Illustrated with Half-Tones and Three Portraits of 
the Author.-Price, $20.00 
Only a Very Few Sets Left. 
THE CRITIC AND GUIDE, 12 Mt. Morris Park W., New York City THE CRITIC AND GUIDE 
Dr. Robinson's Famous Monthly 
It is the most original journal in the country. 
It is the only one of its kind, and is interesting from 
cover to cover. There is no routine dead matter in 
it. Not only are the special problems of the medical 
profession itself dealt with in a vigorous and pro- 
gressive spirit, but the larger, social aspects of medi- 
cine and physiology are discussed in a fearless and 
radical manner. Many problems untouched by other 
publications, such as the sex question in all its varied 
phases, the economic causes of disease and other 
problems in medical sociology, are treated boldly and 
freely from the standpoint of modern science. 
"The Critic and Guide" was the pioneer in the 
propaganda for birth control, venereal prophylaxis, 
sex education of the young, and free discussion of 
sexual problems in general. It contains more interest- 
ing and outspoken matter on these subjects than any 
other journal. While of great value to the practi- 
tioner for therapeutic suggestions of a practical, up- 
to-date and definite character, its editorials and spe- 
cial articles are what make "The Critic and Guide" 
unique among journals. 
Published Monthly Two Dollars a Year 
Single Copies 25 Cents Each 
THE CRITIC AND GUIDE, 12 Mt. Morris Park W., New York City