404 INANITION AND MALNUTRITION 



to regenerate the normal seminiferous tubule. Although variably reduced in 

 frequency, mitoses are usually found even at death from starvation. The 

 cytological changes are those typical for atrophic degeneration, and occur in 

 both total and partial inanition. 



The changes in the stroma of the testis during inanition appear variable. 

 The fibrous connective tissue may show proliferation (with round cell infiltra- 

 tion in thirst), but usually undergoes little change, occasionally showing 

 pigmentation. The specific interstitial cells (of Leydig) likewise appear 

 variable, sometimes appearing atrophic, in other cases hyper trophied, especially 

 in beriberi and upon refeeding after inanition. The fat content of the 

 interstitial cells (also in the Sertoli cells and the epithelium lining the seminal 

 vesicles) appears to belong chiefly to the "permanent" or "sessile" lipoids, 

 which are unaffected by inanition. 



Of the accessory organs, the epididymides show (in rats) a persistent growth 

 in the young during underfeeding, though a marked atrophy during chronic 

 thirst. The human prostate usually appears relatively small in atrophic 

 adults, though not in atrophic infants. A few data indicate an atrophy of the 

 seminal vesicles (especially in fasting frogs) . 



(A) Effects of Total Inanition, or on Water Only 



The data upon the effects in the human species (adult and infant) will be 

 considered first, followed by those for the lower animals. 



Human Adults. — No references to the effects of inanition upon the human 

 male reproductive tract have been found in the earlier literature. Cohnheim 

 ('89) stated that in relative amount of atrophy during inanition, the testes rank 

 next to adipose tissue and the spleen, but it is not clear whether this conclusion 

 was based upon human data. Von Hansemann ('96) noted some increase in 

 the interstitial cells in all human cachexias. Cordes ('98) found the process of 

 human spermatogenesis to be depressed in various forms of acute illness, but 

 ' spermatogenesis does not cease except in chronic malnutrition involving extreme 

 cachexia. Thickening of the walls of the seminiferous tubules and increase 

 in interstitial tissue may occur during malnutrition. After the age of puberty, 

 both the seminiferous epithelium and the interstitial cells contain fat droplets of 

 the "permanent" or "sessile" variety, which do not disappear even in extreme 

 cachexia with tuberculosis or cancer. 



Simmonds ('13, '21) stated that the condition of the sex glands is influenced 

 by the general state of nutrition. In chronic cachexia (especially in tuber- 

 culosis), the testes are small and flabby. Spermatogenesis may be arrested in 

 many chronic diseases (e.g., alcoholism) which do not affect the external appear- 

 ance of the testes. Pigment may occur in the seminiferous cells and the con- 

 nective tissue, especially in senile atrophy. 



In an adult man who died from starvation, Meyer ('17) noted that the 

 bladder and prostate appeared normal. 



Roessle ('19) found no indication of atrophy in the weight of the testes in 

 soldiers with fever or other chronic disorders producing marked loss in body 



