112 LEO LOEB. 



stuffs is diminished below a certain quantity, those cells perish 

 first which are farthest removed from the source of nourishment 

 which is furnished by the capillaries of the theca interna. But 

 the destruction is not limited to the cells adjoining the cavity, 

 but affects in the end the whole granulosa. We see then that under 

 the condition of lack of proper nourishment, a condition which 

 otherwise would occur much later, is observed at an early period 

 of the development of the follicles, and the process of destruction 

 in this case takes place more slowly than in the case of atresia. 

 of the large follicles. It is in the small follicles a more chronic, 

 in the large follicles a sudden, acute process. Those granulosa 

 cells in the small and small-medium follicles which survive for a 

 certain time show approximately the same proliferative energy 

 as the granulosa cells of similar follicles in normal ovaries as 

 the investigations of L. S. N. Walsh have shown. 1 We must 

 therefore assume that the remaining cells are fairly healthy 

 and respond to the stimulus to multiply in a way similar to the 

 granulosa cells in normal follicles, while those cells that are 

 markedly affected by the lack of nourishment become dissolved. 

 We have here to deal with a phenomenon similar to the one which 

 we observed in the case of stationary or retrogressing tumors. 

 In our experimental analysis of tumor growth we noticed that in 

 tumors that had ceased to grow mitoses could still be found 

 rather frequently during a certain period following cessation of 

 growth. This observation led us to the conclusion that the 

 stationary or retrogressing condition was brought about not so 

 much through a complete cessation of growth, as through an 

 increased destruction or solution of cells. 2 We see that in 

 the hypotypical follicles the smallest follicles resist, while in the 

 follicles in which a cavity begins to form processes of degenera- 

 tion set in. We observe the same phenomenon in the destruc- 

 tion of follicles which takes place at the time of ovulation. 

 Here also the largest follicles perish first and the smallest follicles 

 are most resistant. We must assume either that with the 

 growth of the follicles the granulosa cells undergo changes in 

 their constitution, which makes them more sensitive to injurious 



1 Walsh, L. S. N., Journal Exp. Medicine, 1917. 



2 Loeb, Leo, Virchow's Archiv, 1902, CLXVIL, p. 175; 1903, CLXXIL, 345; 

 also E. P. Carson White and Leo Loeb, Centralbl. f. Bact., 1910, LVL, 488. 



