13, or 2.6%, suffered from cold sweats.
14, or 2.8%, suffered from dry heats (dry flushes).
186, or 37.2%, remained free from such attacks of heat or perspiration.
Krieger gives as an example of the “occurrence of new troubles” at the change of life, furunculosis; so also does Boerner. “The discolouration of the face, occurring usually in connexion with pregnancy or with diseases of the reproductive organs, and known as chloasma uterinum,” has been seen by Cohnstein, during the climacteric period, “chiefly in cases in which, owing to some degree of failure of general nutrition, the skin has been thrown into folds.” Wilson regarded prurigo and eczema as the commonest skin-diseases of the climacteric period; whilst Boerner draws attention to a connexion between climacteric conditions and the outbreak of herpes zoster.
Disorders of Metabolism.
Among the disorders of metabolism to which women are especially prone at the climacteric period, we must in the first place allude to obesity (lipomatosis universalis), and to gout (arthritis urica).
Numerous observations have shown us that the time of the change of life, the period between the ages of 40 and 50 years, is the one especially favourable in women to the extensive deposit of fat in the tissues.
In 200 cases of great obesity (lipomatosis universalis) in women, in which I instituted enquiries regarding the age at which an excessive deposit of fat in the tissues had first been noticed, I obtained the following results:
| In early childhood in | 19 cases |
| At the age between 15 and 20 years in | 30 cases |
| At the age between 20 and 30 years in | 45 cases |
| At the age between 30 and 40 years in | 52 cases |
| At the age between 40 and 50 years in | 54 cases |
| At ages over 50 years | 0 cases |
We learn from these figures that it is between the ages of 40 and 50 years that there is the greatest tendency in women for the accumulation of fat; but that as early as between the ages of 30 and 40 years this accumulation may in many instances begin. Speaking generally, there is in women an obvious connexion between the development of obesity and the state of the reproductive functions, inasmuch as at puberty, during the puerperium, and above all at the climacteric, there is a special tendency to the accumulation of fat in the subcutaneous tissues. At the commencement of the menopause, it is more especially in the abdominal wall, the breasts, and the buttocks, that we witness the deposit of fat. In the abdomen, owing to the thickening of the subcutaneous tissues and of the great peritoneal folds—especially of the great omentum—a marked protrusion occurs, whilst the umbilicus becomes more deeply hollowed, and ultimately funnel-shaped. In some instances, the deposit of fat around the navel favours the occurrence of umbilical hernia. After an artificial menopause, induced by oöphorectomy, it has also been noticed in from 42 to 52% of the cases that a marked general deposit of fat has occurred, affecting especially the breasts and the buttocks.