388 INTERNAL SECRETION 



that the suprarenal cortex has a direct influence upon the meta- 

 bolism of the bones. The results of my own experience lead me 

 very strongly to contest Bossi's statement that total or partial 

 epinephrectomy is followed in animals by changes in the skeleton 

 resembling osteomalacia in man. The sole evidence in favour of 

 Bossi's view is the fact, which he observed and others have since 

 confirmed, that the subcutaneous injection of adrenalin produces 

 favourable results in osteomalacia. It is a question, however, 

 and one which must for the present remain unanswered, whether 

 this result is due, less to the pathogenetic significance of the 

 suprarenal, than to the pharmacodynamic action of adrenalin. 



In the present obscure state of our knowledge, we are hot 

 justified in regarding osteomalacia as the expression of the patho- 

 logical affection of a definite internal secretory organ or organs. 

 We can only assume that several of these organs are concerned 

 in the production of osteomalacia; that the principal role is 

 played by the ovary (perhaps, also, as Bucura suggests, the 

 parovarium) and, judging by the incidence among men, by the 

 testis. 



The supposed relationship between the ovarian function and 

 chlorosis led to investigation of the effect of castration upon the 

 composition of the blood. 



Pinzani found that after castration there was increase of the 

 haemoglobin and red corpuscles in the blood of bitches, while 

 Liithje was unable to observe any change in these elements. 

 Breuer and Seiler carried out very exact experiments with bitches 

 which had been castrated at the commencement of sexual matur- 

 ity ; they found that there was an invariable reduction in the 

 haemoglobin contents and in the number of erythrocytes, and that 

 this reduction disappeared again in the course of a few months. 

 Unlike the conditions which obtain in human chlorosis, it was 

 found that, in experiments with animals, the pigment contents 

 always diminished in direct proportion to the number of red 

 corpuscles. 



From the earliest times, the ovaries have been credited with 

 a pathogenetic significance in chlorosis, and the condition has 

 been supposed to result from ovarian anomaly expressed by ner- 

 vous or humoral agency throughout the entire organism. Similar 

 views were held by the great physicians of antiquity, Hippocrates, 

 Galen, and Avicenna. The theory which prevails to-day is that 

 chlorosis is the manifestation of an alteration in the internal 

 secretory activity of the genital glands. The nature of this 

 alteration whether hyper- or hypo-function is, however, still 

 unknown. The premature disappearance of the epiphysal 

 synarthroses, as seen in skiagrams, is regarded as a sign of 

 genital precocity (Tandler). Of the later theories the most 

 interesting are those which attach a special significance to indi- 

 vidiual tissue elements of the ovary. According to Wallart, there 



