PROBLEMS IN OBSTETRICS AND GYNECOLOGY 399 



The results of various experiments in the administration of ova- 

 rian tissue or extract in the human female have in no way helped 

 to throw light on the subject under consideration, nor have they 

 tended to uphold the theory of an internal secretion. The use of 

 the gland in various diseased conditions of the pelvis has not served 

 to give to it any definite therapeutic value. Neither has its admin- 

 istration at the time of the climacteric served to ameliorate or dispel 

 the troubles incident to that period. Results, good, bad, and indif- 

 ferent, have been published, leading strongly to the conclusion that 

 in the cases observed only the same variations in clinical features 

 have been recorded which may be recognized when any group of 

 menopause cases is studied uninfluenced by any medication. 



Whatever the influence of the ovaries may be, it seems to be 

 established that they affect the organism through the circulation 

 and not through the nervous system, and thus support is given to 

 the theory of an internal secretion. Many experiments have been 

 made in transplanting the ovaries of animals from their normal 

 situation to some other, e. g., the peritoneum, subcutaneous tissue, 

 muscles, etc. While after transplantation some of the ovarian 

 tissue usually necroses, the remainder generally lives and continues 

 to functionate, ovums continuing to develop, ripen, and even to 

 escape from follicles. When this activity continues, no matter 

 where the ovary is placed, the genitalia and mammae remain well 

 developed just as though the organ is in its normal position. 



The Role of the Corpus Luteum. Recently the view has been 

 advanced that the internal secretion of .the ovary is produced by 

 the corpus luteum, and that the latter structure exercises very 

 important functions in the female organism. The late Gustav Born, 

 of Breslau, was the first to bring forward this hypothesis, stating 

 that the particular function of the corpus luteum was to favor the 

 imbedding arid development of the fertilized ovum in the uterine 

 mucosa. 



Ludwig Fraenkel has recently published an elaborate paper in 

 which he states his belief that the internal secretion produced by 

 the yellow body keeps up the nutrition of the uterus during repro- 

 ductive life, leads to the phenomena of menstruation, and favors 

 the imbedding and development of the fertilized ovum. Uterine 

 atrophy and amenorrhea are brought about when no corpora lutea 

 are found. Thus are explained the conditions normally found be- 

 fore puberty and after the climacteric. The facts upon which this 

 remarkable hypothesis is based are derived mainly from experi- 

 ments carried out on rabbits, since in these animals the time of 

 occurrence of the various stages of gestation, following insemina- 

 tion, are fairly accurately known. 



In endeavoring to determine the influence of the ovary on im- 



