ADDENDUM 363 



obesity and to the development of hairiness, both of which with respect to 

 abundance and localization are entirely masculine. The influence of the 

 suprarenal cortex on the hairiness is especially unmistakable in all the con- 

 ditions mentioned. We find abnormal hairiness in pseudohermaphroditismus 

 femininus, in the premature development in childhood, in the cortical tumors 

 that develop in the adult organism, perhaps just in the cases of acromegaly 

 with hyperplasia of the cortex, and finally, as is known, in pregnancy, in 

 which hair begins to grow in places that otherwise represent the virile type. 

 Therefore it seems necessary that in future, when the question is asked as to 

 which influences the secondary sexual characters have to thank for their 

 origin, attention should also be paid to the suprarenal cortex. The near re- 

 lationship that the suprarenal cortex and the substances of the sexual glands 

 show embryologically and morphologically seems also to exist in tfie function 

 of these parts. 



Treatment. Up to the present, only the operative treatment of hyper- 

 nephromata has been tried. In every case an early diagnosis is important, as 

 the tumors are often malignant. That result may be expected from operation 

 is shown by the previously mentioned case of Bovin. Perhaps in certain 

 cases a result may be expected from the use of the X-rays. 



3. Tumors of the Suprarenals that Apparently Consist in Cortex and 



Medulla 



Damdsohn has reported a case of melanoma of the suprarenals with nu- 

 merous melanotic metastases. Histologically he found cells of the zona 

 fasciculata and glomerulosa, and also cells of the medulla. The metastases, 

 on chemical examination and on blood-pressure tests, were found to contain 

 adrenalin. Moreover, perhaps here belongs the case of Neuberg, in which in- 

 deed no adrenalin could be demonstrated, but in which an enzyme was found 

 which could change adrenalin into a black pigment. Neuberg believed that 

 the adrenalin further produced in the metastases was the mother substance of 

 the melanin found there. These cases were not accompanied with disturb- 

 ances of the sexual sphere. 



Addendum 



% 



Glynn, from a review of the literature, arrives at about the same opinions 

 as the author with reference to the relation of the suprarenal cortex to the 

 other ductless glands and to sex. He adduces as a further argument for the 

 view that renal hypernephromata arise from suprarenal rests the fact that 

 such rests are rare in the kidney, while hypernephromata are common kidney 

 tumors; and that suprarenal rests in other localities, though comparatively 

 common, especially in early life, rarely produce tumors at all. 



