Physicians constantly experience cases in which the young girl to whom the first menstrual flow having come, without previous knowledge on her part, has supposed it to be the result of a wound, or of a diseased condition, and has attempted to stop the flow by the application of cold water. Even where a partial knowledge has been attained by the girl, she is found to lack the knowledge of the proper hygienic care of herself during the period. The mothers in such cases are criminally negligent, and have alluded a false modesty or prudery to interfere with a natural and necessary maternal duty. The approach of the first menstruation is often accompanied by unusual physical, mental and emotional changes in the young girl. Her nervous system is affected, and she is apt to become irritable or morbid, or even somewhat "flighty." Her appetite may become irregular, and there is often present a craving for indigestible food. A physical languor is often experienced, and there may be pains in the back and legs, chilliness and headaches, and a general upsetting of the usual physical condition, accompanied by a manifestation of peevishness and irritability. These unpleasant symptoms usually disappear when the periodical menstrual flow is permanently established. In fact, they are frequently superseded by the awakened energy and heightened spirits of healthy, normal adolescence. The time of the beginning of the menstrual period varies according to climate, race, condition of health, and temperament. In the tropical countries, menstruation begins from the tenth to the fourteenth year; in temperate countries, from the thirteenth to the sixteenth; in cold countries, from the fifteenth to the twentieth year. The Italian, Hebrew, Spanish, or French girl is apt to menstruate earlier than the English, German, or Swedish girl. The Negro girl menstruates early, as a rule. The full-blooded girl usually menstruates earlier than the anemic one. Normally, menstruation should proceed naturally and without pain or suffering. When pain or suffering is experienced in connection with menstruation, it is simply because of some lack of health in the general system; and when such general health is restored, the trouble ceases. Painful menstruation is called "dysmenorrhea," and arises from several causes, principal among which are the following: Errors in diet, errors in dress, undue exposure, constipation, lack of proper exercise, or to a contracted or congested condition of the Uterus or the Fallopian Tubes. The pain, however, cannot be considered as a feature of normal menstruation, for the latter is no more painful than a normal movement of the bowels--the painful condition results from abnormal conditions, the removal of these conditions resulting in the cure of the complaint.