12 O. BERNER. M.-N. Kl. 



"Mais en faisant la laparotomie, j'en profitai pour examiner la région 

 surrénale, et je trouvai une masse bi-latérale du volume de la moitié d'un 

 rein, surplombant ces organes, et de consistence fibro-lipomateuse." 



"L'examen des pièces enlevées nous montra que l'ovarie gauche était 

 atrophié, mais que l'ovaire droit présentait une tumeur du volume d'une 

 grosse noix. La tumeur de l'ovaire était molle, hémorrhagique, sans végé- 

 tations, sans kystes, et d'un aspect que je n'avais jamais rencontré. Après 

 de mombreuses hésitations, et après avoir cru qu'il s'agissait d'une capsule 

 surrénale aberrante, elle est considérée comme formée par un néoplasme né 

 de l'ovaire lui-même, aux dépens des cellules à lutéine (Masson)." 



TuFFiER has also described this case in the "Revue moderne de Méd. 

 et de Chirurgie", Vol. XII, 1914, where he says: "La tumeur à cellules 

 lutéiniques de l'ovaire formait, en quelque sorte, un corps jaune géant, 

 véritable capsule surrénale accessoire et aberrante, si l'on en croit la théo- 

 rie de Chauffard que Mulon a repris." Blanchard (in a foot-note on 

 P- 53 of "Bull, de l'Acad. de Méd.", 1916) quotes this as being in accord- 

 ance with his own view. 



In Gallais' other patient the phenomena appeared at the age of 17, 

 when there was a vigorous growth of hair and a striking increase in 

 muscular power; and finally the phenomena of an abdominal tumour ap- 

 peared, which, on post-mortem examination, proved to have originated in the 

 left suprarenal gland. On the other hand there were no changes in the 

 genitalia in this patient. 



It will appear, from the cases I have here described, that the features 

 of virilism vary in different cases, while certain characteristics always 

 appear, especially growth of hair and adiposis. We are probably justified 

 in concluding that these phenomena are actually due to the suprarenal 

 gland, as there are several observations analogous to that of Dr. Collett, 

 showing that the phenomena disappear when the tumour is removed. This 

 was the case in the instance recorded by the Swedish physican, Bovin, 

 as also after the first operation in Knowsley Thornton's case, where, 

 however, there was a relapse 2 years later. In neither of these cases, 

 which were both women of about 30 years of age, were there any changes 

 In the external organs of generation. In an addendum to his paper, Glynn 

 states that Dr. Gordon M. Holmes, Birmingham, has performed an opera- 

 tion upon a young woman in whom phenomena of virilism appeared at 

 the age of 20. Four years later a suprarenal tumour was removed, and 

 she once more became normal. 



If we now return to my virile hen, we see that it presents many 

 points of resemblance to these cases of human virilism. In the first place 

 it should be noted that the condition probably depends upon a congenital 

 disposition. This is indicated by the malformation of the oviduct and the 

 aplasia of the ovary, which cannot be explained in any other way than 

 as an anomaly of development. That the tendency to virilism has mani- 



