340 CLINICAL CONSIDERATIONS 



administration of excessive amounts of this hormone induce 

 changes in the reproductive system analogous to those ob- 

 served in the adreno-genital syndrome. It is only a specific 

 type of cortical hyperplasia which is associated with disorders 

 of the reproductive system. The tumors of the interrenal 

 system, described in the preceding chapter, are not associated 

 with changes in the sex glands. It is thus erroneous to ascribe 

 the development of the adreno-genital syndrome to overactiv- 

 ity of the interrenal tissue of the adrenal cortex but we must 

 seek some other functionally distinct unit in the adrenal as the 

 source of the observed disorders. 



The earliest attempts to explain the relation of the adrenals 

 to sex anomalies was based on a consideration of the common 

 embryological origin of the adrenals and the gonads (Gallais, 210 

 Wiesel, 677 Glynn 227 ). As we have already noted in Chapter II, 

 the adrenal cortex is developed from the mesenthelium of the 

 abdominal hollow contiguous to the point of origin of the 

 testicles and the ovary. There is thus an intimacy between 

 the points of development of the adrenal and sex glands. 

 Moreover, the origin of the ovary is hermaphroditic. 359 The 

 ovary passes through a stage in which its cortical portion may 

 be considered female ; its deeper medullary part, male. During 

 subsequent development, this male part remains rudimentary. 

 It is this male part which is so intimately related with the 

 beginning stages of the adrenal cortex. 337 If these fetal testicu- 

 lar cells by developmental anomaly are included in the adrenal 

 they might develop into tumors which physiologically would 

 manifest their testicular origin. Hence one might expect 

 virilism to develop in patients in whom these adrenal growths 

 occur. 



The above theory was propounded by Krabbe 365 and explains 

 to a certain extent the clinical picture associated with the 

 adreno-genital syndrome. However, it is unnecessary to 

 resort to Krabbe 's hypothesis to explain the origin of the dis- 

 orders of the reproductive system which are associated with 



