ual histories of
over one thousand women (_Monatsschrift fuer Geburtshuelfe und
Gynaekologie_, July, 1905). He finds that in the great majority of
women at the present day menstruation is associated with
distinct deterioration of the general health, and diminution of
functional energy. In 26 per cent. local pain, general malaise,
and mental and nervous anomalies coexisted; in larger proportion
come the cases in which local pain, general weak health or
psychic abnormality was experienced alone at this period. In 16
per cent. only none of these symptoms were experienced. In a very
small separate group the physical and mental functions were
stronger during this period, but in half of these cases there was
distinct disturbance during the intermenstrual period. Tobler
concludes that, while menstruation itself is physiological, all
these disturbances are pathological.

As far as England is concerned, at a discussion of normal and
painful menstruation at a meeting of the British Association of
Registered Medical Women on the 7th of July, 1908, it was stated
by Miss Bentham that 50 per cent. of girls in good position
suffered from painful menstruation. Mrs. Dunnett said it usually
occurred between the ages of twenty-four and thirty, being
frequently due to neglect to rest during menstruation in the
earlier years, and Mrs. Grainger Evans had found that this
condition was very common among elementary school teachers who
had worked hard for examinations during early girlhood.

In America various investigations have been carried out, showing
the prevalence of disturbance in the sexual health of school
girls and young women. Thus Dr. Helen P. Kennedy obtained
elaborate data concerning the menstrual life of one hundred and
twenty-five high school girls of the average age of eighteen
("Effect of High School Work upon Girls During Adolescence,"
_Pedagogical Seminary_, June, 1896). Only twenty-eight felt no
pain during the period; half the total number experienced
disagreeable symptoms before the period (such as headache,
malaise, irritability of temper), while forty-four complained of
other symptoms besides pain during the period (especially
headache and great weakness). Jane Kelley Sabine (quoted in
_Boston Medical and Surgical Journal_, Sept. 15, 1904) found in
New England schools