This is a report of Dr. Macnaughton-Jones' address to the British Gynæcological Society at the close of his year of office as president. The writer points out that the present state of our knowledge only admits of very tentative opinions on the relation of sexual function to psychic processes. The first point dealt with is the influence of menstruation on such processes; the magnitude of the alterations in the entire genital tract at each menstrual period is indicated, and note is taken of recent researches into the effects of ovarian secretion on general and nervous metabolism, especially as illustrated in the pathology of osteomalacia. Having touched on the various minor neuroses which appear to be reflex results of genital disorders, the author discusses briefly the relation of such disorders to the graver neuroses and to mental disease. In this connection, he refers to the published clinical evidence (chiefly by American authors) of insanity and epilepsy associated with pelvic disease and disappearing after the removal of the diseased organs. Per contra, however, attention is drawn to the large number of cases of insanity with pelvic disease where operation produces no good effect on the mental symptoms, and two personal observations of this nature are mentioned. The author leans to the opinion—shared by most of the leading British alienists, whom he quotes—that true sexual insanity is very rare. The experience of a number of operators on this point and on the cognate question of postoperative insanity is then summarised. The general conclusion to be drawn from the available facts would appear to be that disease of the generative organs can produce insanity only in predisposed subjects; and that it is in the same class of subjects that operative interference is likely to cause mental disorder.
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