372 INTERNAL SECRETIONS 



Asch (1911, 1921) in Breslau. The skeleton was not that of 

 a child, the epiphyses being partly ossified. The larynx was 

 like that in a man after puberty. Some kind of menstruation 

 took place about twice in the year. The patient developed intel- 

 lectually in a satisfactory manner. Physically the development 

 finally stopped ; at the age of eighteen the body height was 121 

 cm., or the same as it was at the age of nine. The body 

 weight was 30 kgr. at the age of nine and 40 kgr. at the age 

 of eighteen. A tumour in the right hypochondrium was found 

 when the patient was examined at the age of eighteen. The 

 tumour grew rapidly during the last year, and it was supposed 

 to be an hypernephroma. The tumour was removed, and it 

 was stated to be really an hypernephroma weighing about 

 3 kgr., and filling up almost the whole abdominal cavity. A 

 small but normally developed uterus and tubes were present. 

 Both ovaries were white, smooth, without visible corpora 

 lutea, and without cj^sts. The patient died soon after the 

 operation. 



Similar cases in which mascuHnization of a female individual 

 was caused by an hypernephroma or a neoplasm of the adrenals 

 are not very rare. In the " Institut fiir Sexualwissenschaft" in 

 Berlin, I had the opportunity of seeing a new-born child, 

 brought there for examination in order to ascertain the sex. 

 There was a penis-like organ, much bigger than in a normal 

 new-born boy; the organ was hypospadic. There was a 

 formation resembling an empty scrotal sac. The general 

 impression based on the examination of the external genitaha 

 was that it was a boy with an hypospadic penis and unde- 

 scended testicles. The child died some months afterwards. 

 The examination made by Dr. Weil revealed normal female 

 internal genitalia and somewhat hypertrophied adrenals. 



Besides those cases where an hypernephroma causes mascu- 

 linization of a female individual, others are known where a 

 male individual undergoes a rapid development to male 

 sexual maturity, the cases of so-called pubertas praecox or 

 sexual precocity. Krahhe (1921) lately has given a summary 

 of all the cases described in the medical literature. Krabbe 

 concluded from his description that the hypernephroma, 

 being a masculinizing factor, will cause masculinization in the 

 female and acceleration of sexual development in the male. 

 But there are also cases where a feminization of a male 



