DERANGED SEX-CHARACTERISTICS 167 



It is important to note that there is no case on record Suprarenal 

 of a suprarenal lesion in a woman after the menopause tSS^Ss and 



associated with changes in the secondary characteristics, derange- 



ments of sex- 

 Yet we know that often after this period of life the character- 



characteristics may normally incline towards the mascu- ls 

 line type, the skin becoming coarse and hair growing 

 on the face. I have, however, seen a suprarenal tumour 

 in a duck of considerable age, which had partially acquired 

 the plumage of the drake. 



The paradoxical circumstance that in women after 

 the climacteric suprarenal lesions cause no considerable 

 development of the masculine characteristics, which, 

 however, may occur normally after that period of life, 

 may be explained by the fact that Sex, as such, has 

 ceased to exist ; and that although the withdrawal of 

 certain feminine functions and characteristics may lead 

 to the latent masculinity developing to a slight extent, 

 yet no further sex-demonstration can be aroused, even 

 though the masculinity-producing organs be disturbed. 



During the reproductive period of life the changes 

 in the sex-characters of women, which may be brought 

 about by suprarenal lesions, are remarkable. In one 

 case of Krafft-Ebing, quoted by Halban 1 , the voice 

 which was previously soprano became " like that of a 

 lieutenant ", and the woman, formerly gentle and 

 amenable, became rough and aggressive. Amenorrhcea 

 is a constant phenomenon in these circumstances, and 

 the breasts atrophy. In fact, all the essentially feminine 

 attributes of mind and body retrogress or disappear, 

 while the male characteristics become pronounced. 

 I have just explained why this can occur during the 

 reproductive period and not after the menopause. 



It has been mentioned that the pituitary is largely Pituitary 

 concerned in promoting the growth of bone and the 



retention of calcium salts. It is interesting, therefore, ments of se2 ^ 

 to note that when there is hyperplasia of this organ in tetios. 

 women, such as is seen in acromegaly, the sex-character- 

 istics are disturbed. Every woman with acromegaly 

 1 Halban, J., Archiv.f. Gynak., 1903, vol. Ixx, p. 205. 



