ADRENOGENITAL SYNDROME 341 



adrenal tumors. As we have seen in Chapter IV, the adrenal 

 cortex of man (in whom alone the adreno-genital syndrome has 

 been observed) contains a tissue which is anatomically and 

 functionally distinct from the rest of the cortex. This tissue 

 which we have designated as the androgenic zone is normally 

 only temporary in its existence disappearing in the first years 

 of life, but sometimes remains as a few scattered cells (the 

 juxta-medullary zone) in the adult. It would seem most logi- 

 cal, therefore, to ascribe to this androgenic tissue the occur- 

 rence of the disorders of the reproductive system which are 

 associated with tumors of the adrenals. The exact embryologi- 

 cal origin of the androgenic zone has not been determined. It 

 may well be that it has a common origin with the "testicular" 

 cells of the ovary, asumed by Krabbe 365 to be the cause of the 

 adreno-genital syndrome. 



The differentiation of the androgenic tissue as a unit distinct 

 functionally from the remainder of the adrenal cortex would 

 explain the fact that adenoma or carcinoma of the cortex 

 proper do not give rise (Chapter XXII) to abnormalities of the 

 reproductive system. It would also account for the failure of 

 large doses of the cortical hormone to affect the reproductive 

 system. Although Britton and his co-workers 127 have claimed 

 that extracts of the adrenal cortex of cattle induce "precocious" 

 maturity in rats, all subsequent observers (Castello et alii, i09 

 Cleghorn, 115 Howard and Grollman, 321 Simpson et alii, 575 and 

 others who have investigated the problem) have disproven 

 Britton's contentions. 



The author realizes that the views set forth in the present 

 volume regarding the functional independence and the clinical 

 significance of androgenic tissue require further experimental 

 work to establish them upon a firm basis. However, although 

 theoretical, the view advanced is in accord with all the known 

 facts and permits one to account logically for the adreno-genital 

 relationships. The use of this theory avoids the chaotic con- 

 fusion otherwise encountered in trying to account for the rela- 

 tion between the adrenals and the reproductive system. 



