THE FUNCTION OF THE OVARY 221. 
PLURIGLANDULAR ASPECTS OF OVARIAN FUNCTION 
According to Carey Culbertson ‘the climacteric is 
monoglandular only in its etiology: in its manifesta- 
tions it is distinctly pluriglandular.” ‘* Marafion® in 
his monograph goes into great detail on this pluri- 
glandular phase of the menopause. He believes that 
the ovarian secretion is not a single chemical entity, 
but a complex group of hormones each having a dif- 
ferent activity. These he divides into genital, sexual 
and general hormones. The genital hormones control 
particularly the menstrual process, the sexual hor- 
mones conserve the morphological sex characteristics, 
and the general hormones influence and assist in all 
the functions of the organism. If the suppression of 
ovarian hormone function is gradual or physiologic, 
as in the menopause, the insufficiency of some of them 
is made up by others from remote sources. He feels 
that this explains the error of considering under one 
head all the disturbances which characterize the meno- 
pause. The failure of the menses indicates the disap- 
pearance only of the genital hormones which are prob- 
ably elaborated in the corpora lutea. The other hor- 
mones, which apparently are produced in the follicular 
interstitial tissues, either may still persist, or disap- 
pear first, as the various clinical symptoms show. The 
menopause does not begin with the irregularity of 
the catamenia, but long before, with the appearance 
of the various general disturbances. The general 
symptoms of the failure of the ovarian hormones also 
persist long after the complete suppression of the 
menses. Therefore, the menopause must be consid- 
ered only as a phase of the critical age, and not synony- 
mous with it. The critical age is divided into three 
periods: the premenopause, the menopause, and the 
postmenopause.® 
According to Marafion the adrenal glands do not 
follow the development of the other organs, but con- 
