360 THE DISEASES OF THE SUPRARENAL APPARATUS 



beard, mustache, and hair on the trunk. At the same time a tumor developed 

 in the abdomen. Death occurred. Autopsy showed a cystoma pseudomu- 

 cinosum proceeding from the right ovary. The clitoris was appreciably 

 enlarged (autopsy only partial, no statement as to the suprarenals) . 



Case of Goldschwend. Thirty-nine-year-old woman, had five children. 

 Cessation of menses three years ago. For four months pains in abdomen, 

 development of an abdominal tumor, development of a mustache and 

 beard, and hair on the abdomen, malignant adenoma of the left supra- 

 renal, uterus and ovaries small, epiphysis and hypophysis normal. 



Case of Launois, Pinard, and Gallais.- Nineteen-year-old girl. Men- 

 struated first at the age of thirteen years. At seventeen violent vomiting, 

 gradually colossal obesity, mental changes. Cessation of menstruation, 

 emaciation, then diffuse depilation, and only then hypertrichosis and 

 myasthenia. The girl appeared to be much older than she was, black beard 

 and mustache. Tumor of the right suprarenal. 



Possibly also the following case of Dalche belongs here; twenty-eight-year- 

 old woman, body quite feminine, for five years development of a mustache 

 and beard and (after miscarriage) cessation of menstruation. Breasts well 

 developed, voice feminine, uterus small, atrophy of the inner genitalia, hyper- 

 trichosis on abdomen, slight manifestations of hyperthyrosis, there were no 

 other symptoms of a suprarenal tumor. 



Also a case has been reported that began at the menopause. 



Case of Santi. Fifty-three-year-old woman, two normal pregnancies, 

 menstruation always regular until six years ago. Then the periods became 

 more frequent, until the woman lost blood almost constantly. Enlargement 

 of the abdomen, enormous obesity. Autopsy showed a tumor of the kidney 

 proceeding from separated suprarenal germs, and a similar tumor of the 

 ovary. No statement as to hairiness. 



Under this category may well belong the case of Vollbracht, mentioned 

 by v. Neusser and Wiesel. The case was designated by the last named 

 authors as Addison's disease with contrasexual sexual characters. 



Let us look over the cases I have mentioned. In women simultaneously 

 with the development of a hypernephroma there occur cessation of the 

 menses, hypertrichosis of a definite localization (linea alba, growth of beard) 

 and obesity. The development of hypernephroma at the menopause ap- 

 parently gives rise only to obesity. 



III. Cases of Pseudohermaphroditism. Marchand first reported the 

 autopsy findings in a fifty-year-old individual who in life was always 

 regarded as a man. 



The individual showed masculine body conformation and masculine hairi- 

 ness of the face; autopsy showed a hermaphroditismus spurius femininus, a 

 very large penis-like clitoris, a distinct scrotum and a rather large prostate; 

 there was also a vagina with the traces of a hymen, a uterus, and atrophic 



