Chapter XXIII 



THE ADRENO-GENITAL SYNDROME 



Certain pathological abnormalities involving the reproduc- 

 tive system are regularly accompanied by anatomical changes 

 in the adrenals. Although numerous reports are extant de- 

 scribing obvious examples of the adreno-genital syndrome, the 

 first extensive work, recognizing the relation of certain abnor- 

 mal developments of the sex organs to an abnormal growth in 

 the adrenal, was that of Bulloch and Sequeira" in 1905. Gal- 

 lais, 210 in 1912, published a voluminous thesis on the subject 

 and clearly indicated the clinical picture as it occurs in adult 

 life. Glynn 227 in the same year also described at length the 

 condition as it occurs in women and children. 18 



In the absence of knowledge of the function of the adrenals, 

 it is not surprising that early considerations of the adreno-geni- 

 tal syndrome should have been rather confusing. This was 

 particularly so since most adrenal anomalies are not accom- 

 panied by sexual changes nor are the latter in the majority of 

 cases accompanied by changes in the adrenal. Unless a clear 

 differentiation is made between the androgenic zone and the 

 remainder of the cortex one cannot describe logically the rela- 

 tion of the adrenals to certain changes in the reproductive 

 system and the secondary sex characteristics. 



Previous authors have attributed the development of the 

 adreno-genital syndrome to hyperfunction of the adrenal cor- 

 tex with the elaboration of an excess amount of the hormone 

 specific to the interrenal tissue. This idea, however, is not in 

 accord with the available facts concerning the interrenal tissue. 

 As we have seen in Chapter XIV, the adrenal cortical hormone, 

 although essential for maintaining the normal reproductive 

 function does not control reproductive activity. Nor does the 



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