184 THE SEX-COMPLEX 



Effect of the nervous and muscular irritability, which are constant 

 ^ features of these cases. In pregnancy and lactation, 



ovaran 



nowever > there is a large demand for calcium over and 

 holism. above the amount necessary for the normal maternal 

 metabolism, and, as a result, softening of the bones may 

 occur. This condition is known as osteomalacia. 

 Osteomaiacia. Osteomalacia is not common in England, but is more 

 frequently encountered in other countries such as Italy, 

 Austria and India. The disease used to be treated by 

 removal of the ovaries, and many patients were cured. 

 Figure 61 is of a section of an ovary, which was greatly 

 enlarged, from a case of osteomalacia. It will be seen 

 that the interstitial cells are very prominent, much more 

 so than in normal ovaries during pregnancy. 



Hyperpiasia Wallart 1 was probably the first carefully to examine 



ceiishi rStitial the ovaries in this disease by histological methods. 



osteomalacia. The ovaries from five cases are described. In four the 



interstitial cells were particularly well developed. More- 



over, he states that this is always so in osteomalacia, 



whether the patient be pregnant or not ; and he agrees 



with Bossi 2 that osteomalacia is due to vasodilatation, 



which affects the vessels of the bone-marrow as ^vell as 



those of other tissues. 



Suprarenin Some years ago Bossi 2 of Genoa suggested the 



and infundi- . -, -, 



buiinin injection of suprarenal extract as an alternative to 

 osteomalacia oo ph rectom y ; and apparently many cures have been 

 effected by this treatment. I have also suggested 

 treatment with injections of infundibular extract, and 

 Miss Kate Knowles, of Srinagar, Kashmir, working in 

 conjunction with me, has found that infundibulin is 

 most beneficial in a number of cases of this disease. 



It may, therefore, be argued that there is insufficiency 

 in the suprarenals and pituitary as well as an excess of 

 ovarian secretion ; and this, indeed, is quite possible. 

 On the other hand, it may be suggested, as has been 

 done by Bossi and Wallart, that the general vasodilatation 

 caused by hyperplasia of the intestitia] cells is a primary 



1 Wallart, J., Zeitsch.f. Geb. u. Gynalc., 1908, vol. Ixi, p. 581. 



2 Bossi, L, M., Centralblf. Qynak., 1907, vol. xxxi, p. 69, 



