In Germany Tobler has investigated the menstrual histories of over one thousand women (_Monatsschrift für Geburtshülfe und Gynäkologie_, 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.