With some the chill is the precursor of the “hot spell.” The flashes occur at all times of day, and often one awakens with them in the night. They may occur but two or three times a day or every ten or fifteen minutes, making one wretched by their frequency. They are often the result of some sudden emotion as fright, anger, grief or anxiety. They are wonderfully the product of thought. By observation the patient will notice that they are also more frequent after drinking wine, tea and coffee, or partaking of stimulating food. Sometimes nausea and vomiting accompany flushings, as well as a feeling of weakness and _malaise_. _Profuse perspiration_, sometimes so copious as to saturate the bed clothing, is also a common symptom of this period. This may follow the hot flushes or occur independently, but occurs more usually during sleep. It may accompany mental excitement of any kind. _Uterine Hemorrhage_, common to the “change of life,” is the only peculiar symptom which really need cause any special anxiety. This may occur once a month or at longer intervals, or may be almost constant. It may become so profuse as to endanger the life of the patient. Indeed, one is often surprised that life can be sustained under the great loss of blood that some experience. The _appetite_ is sometimes capricious and fitful, as during pregnancy, or at the beginning of menstruation. Frequent derangements of stomach, liver and kidneys occur. _Skin diseases_, often accompanying this period, are especially distressing from being attended with great itching. One also may have constipation, or diarrhea, swelled limbs or joints, swelled breasts, headaches, with heat and burning in top of the head or a sore pain at base of the brain; dizziness, dimness of vision with floating specks before the eyes, loss of voice and aching at the base of the tongue, insomnia, strange cravings, difficult breathing, neuralgia, hysteria, etc. _Tumors_, _cancers_, _polypi_, etc., are more frequent during the meno-pause than at any other time of life. If the neck of the womb has been injured by attempts at abortion or indurations caused by frequent applications of caustics, conditions are produced that are liable to result in cancer. “_The mental symptoms_ are quite as marked and prominent in most cases as are those which relate to any part of the system. _Loss of memory_ to a greater or less extent is apt to be first and most noticeable. Frequently there is an entire and most remarkable change in disposition. A kind, patient mother, or forbearing, confiding, exemplary wife, becomes irritable, unreasonable and suspicious.