Tilt was the author of the only English book on the female climacteric published in the 19th century. This short historic sketch is primarily concerned with the evaluation of his work. It only hints at the differences between conditions on the opposite sides of the English Channel which encouraged the expression of climacteric disturbances to the south of it but not to the north. Though Tilt acted as an agent of diffusion for the medical concepts developed in France he had hardly any listeners. During the last quarter of the century, however, conditions changed greatly increasing stress among women. The work of Tilt then supplied a ready mould into which the many nebulous complaints presented by women could be fitted. Ménopause became anglicized to menopause: but though Tilt was "vindicated" he was also forgotten. His style was dated and his treatment out of date. His strong advocacy of sedation is still followed but his pioneering of statistical investigation of the climacteric is largely forgotten. Endocrinal research has made us neglect all that happened before it; examination of the past, its achievements and mistakes, may yet, however, teach us a great deal.