398 GYNECOLOGY 



are ductless glands, whose internal secretion affects general meta- 

 bolic processes. 



Several years ago, it was noted that in many cases of osteoma- 

 lacia the disease could be checked by removal of the ovaries. Feh- 

 ling, a pioneer in this line of work, made a careful study of the urine 

 in his cases, but gained no information as to metabolic changes by 

 comparing its condition before and after operation. 



In 1894 and 1896, Neumann stated that removal of the ovaries 

 in this disease exercised a marked effect in lessening the excretion 

 of magnesium, calcium, and phosphorus, as well as diminishing 

 proteid disintegration. Later, Neumann and Vas experimented on 

 normal female animals, and found that Merck's ovarian tabloids, 

 even in large doses, did not appreciably alter the quantity of nitro- 

 gen or phosphorus in the urine. They found, however, that there 

 was an increased excretion of these when their own preparation 

 of cow's ovary was administered. They also noticed no pronounced 

 alteration in the phosphorus excretion after removal of ovaries 

 from animals. When ovarian tabloids were given to spayed ani- 

 mals, there was increased excretion of calcium and phosphorus, and 

 less marked nitrogenous excretion. 



The experiments of Curatulo and Tarulli, in 1895, have attracted 

 a good deal of notice. They fed bitches on a regular diet until there 

 was a uniform average daily excretion of phosphorus and nitrogen. 

 The ovaries were then removed, and thereafter the excretion of 

 phosphorus was much diminished. They concluded that the ovaries 

 produced an internal secretion, of unknown nature, which influ- 

 enced the oxidation of organic substances containing phosphorus 

 which enter into the structure of bone. In accordance with their 

 view, it has been widely believed that the beneficial influence of 

 the removal of the ovaries in osteomalacia was due to the reten- 

 tion of more phosphorus in the system and its deposition in the 

 bones in the shape of phosphates. 



In 1899, Falk repeated these experiments, but did not arrive at 

 the same conclusions. After removal of the ovaries in two bitches, 

 he noticed no difference in the amount of phosphorus excretion. 



Moreover, recent investigations regarding the source of the ex- 

 creted phosphorus tend to lessen the value of these experiments. 

 They appear to show that much of the phosphorus is derived from 

 nucleoproteid in food, and it is possible that the increased excre- 

 tion after the administration of ovarian tissue or extract is thus 

 explained. Curatulo also holds that the ovarian secretion favors 

 the oxidation of carbohydrates and of fatty substances, and ex- 

 plains the tendency to corpulency when the ovaries are removed 

 in the reproductive period of life, or after the menopause, as due 

 to the loss of the ovarian secretion. 



