374 THE DISEASES OF THE SEXUAL GLANDS 



ground of transplantation experiments inclines to this view. Finally Biedl 

 supposes a hermaphroditic rudiment of the sexual glands. The secondary 

 sexual characters develop either in a masculine or a feminine direction 

 according as to whether the development of the masculine or feminine 

 internal secretory sexual glands predominate. The occurrence of heterolog- 

 ous sexual characters is explained by Biedl by the supposition that the 

 internal secretory portion of the sexual glands that belongs to the other sex 

 obtains the upper hand. 



A further problem lies in the fact whether the sexual characters in their 

 development especially depend exclusively on the sexual glands, or whether 

 much more do they not rather receive decisive influences from the other 

 ductless glands. 



The discussion of all these questions makes necessary not only the resort 

 to experimental pathology and physiology, but to an abundance of clinical 

 observations. It seems to me therefore suitable to describe first the genera- 

 tive apparatus, then to detail the most important clinical observations and 

 only later to enter into the discussion of these questions. I need hardly 

 emphasize that judging from the contradictory nature of the opinions, the 

 discussion must be strongly tinged subjectively. 



B. The Generative Apparatus 



As previously mentioned, the interstitial glands are of mesodermal origin. 

 This has also been assumed for the generative apparatus, although to me 

 the view seems very noteworthy that the generative apparatus (spermato- 

 gonia in man, follicular apparatus in women) develop out of the primordial 

 cells. Then the interstitial glands and generative apparatus are differenti- 

 ated embryologically. Primordial follicles and Sertoli's cells are demon- 

 strable already at an early embryological stage. 



We shall first take note of the development of the generative glands and 

 their influence on the total organism, in woman. The development of the 

 follicular apparatus is quite gradual. First -at the time of puberty, together 

 with the beginning of maturation of the interstitial glands does it come to 

 full development; at the same time too with an enormous growth impulse 

 for the breasts and the beginning of menstruation. While now in man after 

 complete maturity there enters the condition of rather continuous function of 

 the sexual glands and especially the generative apparatus, in woman the 

 activity of the sexual glands and especially of the generative apparatus 

 is subjected to periodic variation. With the periodically recurring ovula- 

 tion and menstruation, there enters into the vital processes a noticeable wave 

 movement that has been deeply studied by Goodman, Jacobi, Rabutau, 

 Reinl, Ott, and others. We must distinguish a premenstrual period, a period 

 of menstruation and a postmenstrual interval. During the premenstrual 



