THE FUNCTION OP 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." 14 Maranon 8 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. 8 



According to Maranon the adrenal glands do not 

 follow the development of the other organs, but con- 



