This unique, comprehensive manual of all aspects of human sexuality is an important piece of medico/sexual/psychological history. The author was a specialist sexologist practising in Poland between 1920 and 1939. The book received universal acclaim from the Polish press of the day and went to three editions prior to WWII.

Intended for the educated laity, this is a serious work, much of which is as relevant now as when the book was first written.

It is quite understandable that in the same way as the sudden invasion by some poison causes a strong reaction in our system - which gradually becomes accustomed to it and creates an advanced degree of tolerance to it - so sudden abstinence has a very strong impact. This frequently leads to disturbances in the psychic sphere. The best examples of this are morphinomania, cocainomania and alcoholism. We can conduct a fearless analogy here with the action of sex hormones whose sudden influx during puberty causes youthful disturbances. The cessation of inflow of these substances in menopause also provokes disturbances, albeit of quite a different character. These we will discuss below.

First of all, where women are concerned, most obvious during this period are the changes and sensations in the nervous system. Sudden attacks of "hot flushes" with the accompanying reddening of the face are a frequent and characteristic symptom of commencing menopause. These "blows to the head", as some patients describe them, go in tandem with vertigo, noises in the ears, fainting spells and sometimes nausea.

Also in this period we come across an extremely stubborn form of puritus vulvae et vaginae which resists all attempts at therapy and compels radical interference by surgical means because the intensity of the itching deprives the victim of sleep and often leads to ultimate despair and even suicide. The causes of suicide in women during this period - constituting about 50% of incidents of this type - also include the states of hypochondria and melancholy frequently observed during menopause.

Among physical changes we must include senile involution in the sex organs: the mucous membrane diminishes, secretions from Bartolini's glands cease and the sheath becomes dry. The womb and ovaries shrink markedly and during this period malignant tumours frequently appear in the reproductive apparatus.

Mood changes in women during this genuinely "dangerous age" should also be mentioned in order to understand the full import of this critical time not only for the woman, but for all those close to her.

Hitherto cheerful and well-balanced, the woman suddenly becomes very sensitive, changeable and capricious in her make-up. She ill-treats and tyrannises those around her and becomes suddenly jealous in relations with her husband, digging out from the depths of memory some old, long-forgotten peccadilloes which cause belated - yet no less unpleasant - rows and create a hell out of a previously peaceful home.

This belated jealousy sometimes leads the husband to despair, so that he sees in his wife's lover - should one still be found - his true friend and saviour since the real cause of the jealousy is recollection of that which was and comparison with that which now is. The situation presents itself thus: in a very significant number of women during menopause sexual desire explodes with elemental force, while the husband at this time has become a "sexual retiree". This results in jealousy over what is past, since this is now seen as the reason for his present inadequacy (impotence).

Overwhelmed by sexual desire during this period, women throw themselves uncritically into the arms of various undesirable types, of whom there is never a lack anywhere if only the victim is wealthy enough to pay for all their foibles. A classic example of this situation is the famous affair of Wilhelm's (Transl.: presumably the reference is to Keiser Wilhelm) sister, Mme. Zubkov, which ended so tragically for her.

Ladies of this type completely lose all critical faculties under the influence of an overwhelming desire and exceed the least experienced teen-ager in their recklessness and behaviour.

They flirt and practice coquetry with zeal and launch upon all sorts of amorous adventures as if wanting to make up for lost time. Their principal slogan is" "Carpe diem" - especially as not many such days remain.

Of course, the picture painted above should be treated as an exception. Normally the period of menopause is characterised rather by spiritual depression, sometimes accompanied by serious mental disturbances. Sadness and fear fill a woman's soul during this time; it seems to her that she is not needed anywhere or by anyone. She constantly thinks only of ways of removing herself from active life in order not to obstruct her children - to whom she wants to surrender her position, leaving nothing for herself.

However, the most dangerous disturbances during this critical period concern the state of the mind. We frequently note a condition of severe insanity (paranoia) or melancholy. These are the so-called climacteric psychoses, usually incurable, which develop on the basis of hereditary encumbrance in psychopathic personalities. Hallucinations of all kinds, persecution and religious/mystic manias are by no means rare - and all of it clearly has an erotic colouring. 

It appears to such patients that some man is constantly persecuting them with his love, that he comes into their bed at night and enters into close contact with them in the daytime with the aid of telepathy and modern electro-technical devices. Hallucinations fall within the sexual sphere and sufferers frequently claim that this man or that has had intercourse with them and they became pregnant.

It is easy to guess the sort of drastic situation in which people can find themselves by virtue of their profession (doctors, dentists, spiritual counsellors) when they come into contact with this type of sick female.

Such, in general outline, are the changes and disturbances which are produced in the physical and psychic make-up of a woman during the menopause.

For me it is more than certain that the picture of the "classic mother-in-law" with all her characteristics and faults - that inexhaustible arsenal of burlesque and comedy at the bottom of which lies the tragedy of the ageing woman - is a true picture of the menopausal period.