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The shock which originated the attack gave form and reality to fears and doubts which had been assailing her for some time, and to the influence of which she was specially liable at this time by the lowered physiological tension, the result of her previous menorrhagia, and by the fact that the comparative ease and comfort of her later life had given her opportunities for introspection absent during her previous life of struggle for and interest in others.

It was therefore frequently neglected, and the girl, with hereditary predisposition to menorrhagia, increased by malarial infection, and also by certain rheumatic tendencies, was allowed to expend upon elementary text-books an amount of time, attention, and nervous energy, that would have been deemed excessive for the most valuable intellectual pursuits.

The following case illustrates one of the ways in which our present school methods of teaching girls generate a menorrhagia and its consequent evils. Miss A , a healthy, bright, intelligent girl, entered a female school, an institution that is commonly but oddly called a seminary for girls, in the State of New York, at the age of fifteen.

A large number of American girls become affected with amenorrhea or menorrhagia solely on account of excessive mental exertion at such periodical epochs of incapacity. 3d. It is possible to educate girls properly, only by regularly intermitting their studies at such times, and by "conceding to nature her moderate but inexorable demand for rest during one week out of four." 4th.

Second, that just before the entrance to school, and the disturbance of menstruation, the girl had been living in a malarial district, and had suffered from malarial infection, which is again a frequent cause of menorrhagia.

She was a good student, and conscientiously devoted all her time, with the exception of ordinary vacations, to the labor of her education. She made herself mistress of several languages, and accomplished in many ways. The catamenial function appeared normally, and, with the exception of occasional slight attacks of menorrhagia, was normally performed during the whole period of her education.

Their teachers have known nothing of the amenorrhoea, menorrhagia, dysmenorrhoea, or leucorrhoea which the pupils have sedulously concealed and disregarded; and the cunning devices of dress have covered up all external evidences of defect; and so, on graduation day, they are pointed out by their instructors to admiring committees as rosy specimens of both physical and intellectual education.

Sometimes they produce an insufficient performance of it; and this, by closing an avenue of elimination, poisons the blood, and depraves the organization. The host of ills thus induced are known to physicians and to the sufferers as amenorrhoea, menorrhagia, dysmenorrhoea, hysteria, anemia, chorea, and the like.

Fortunately graduation soon occurred, and unintermitted, sustained labor was no longer enforced. The menorrhagia ceased, but persistent dysmenorrhoea now indicates the neuralgic friction of an imperfectly developed reproductive apparatus. Doubtless the evil of her education will infect her whole life. The next case is drawn from different social surroundings.

It often happens, however, during the first critical epoch, which is isochronal with the technical educational period of a girl, that after a few occasions of catamenial hemorrhage, moderate perhaps but still hemorrhage, which are not heeded, the conservative force of Nature steps in, and saves the blood by arresting the function. In such instances, amenorrhoea is a result of menorrhagia.