382 THE DISEASES OF THE SEXUAL GLANDS 



sixteen such cases from the literature and Halban has added three more. 

 It looks very much now as though the removal of the ovary later exe'rcises 

 a favorable influence on milk-production, as breeders state that castrated 

 cows yield abundant milk. Noteworthy in this respect is the case of Foges. 

 After a labor a woman experienced a secretion of milk for seventeen years. 

 During this time constant amenorrhea existed. After seventeen years men- 

 struation a new conception occurred. After the labor the milk-secretion 

 continued again for six years. 



Milk usually comes on two or four days after labor. This whether the 

 birth takes place at normal time or whether there has been a miscarriage. 

 Secretion of milk has even been observed after an abortion as early as the 

 second month of pregnancy. As the pregnancy-hyperplasia of the breasts 

 is independent of the ovaries, Starling and Lane-Claypon have regarded the 

 fetus as the source of the mammary gland hormone. Actually they even 

 succeeded in inducing growth of the mammary glands by injection of ex- 

 tract of embryos into the peritoneal cavity of rabbits that had not yet been 

 covered. Also Biedel and Konigstein lend themselves to this view, as has 

 also Fod who recently on the ground of his experiment has upheld the 

 opinion that the mammary glandular hormone was not specific in kind. 

 Against this, Halban has upheld the view that the pregnancy-hyperplasia of 

 the breasts is produced by a hormone, that proceeds from the chorionic 

 epithelium of the placenta. Halban bases his view on the following observa- 

 tions. The pregnancy-hyperplasia of the breasts can still develop if 

 the fetus has been dead a long time but the placenta remains living. If, 

 however, the placenta too dies, the further development of the mammary 

 glands ceases and milk begins to flow. Halban further observed two casee of 

 cystic mole, in which secretion of milk began after expulsion of the mole. 

 Halban sets forth that the chorionic villi develop from the fertilized egg 

 and in spite of enormous growth until the end of pregnancy undergo but 

 little differentiation. By the copulation of spermatozoa and ovum is ex- 

 plained the fact that the hormonopoietic action of chorionic epithelium is 

 stronger than that of the ovum alone. Hardly anything can be objected 

 against Halban's clinical observations. On the contrary it seems to be not 

 refuted that also from the fetus may mammary glandular hormones proceed, 

 as indeed the chorionic epithelium may live without fetus, but not the fetus 

 without chorionic epithelium. Hence it seems to me that the views of 

 Halban and of Starling are not irreconcilable. 



Yet a few remarks concerning the onflow ["Einschiessen," literally a 

 shooting in] of the milk, which, as previously mentioned, usually occurs on the 

 second to fourth day after birth. It was formerly regarded that the cause of 

 the onflow was the act of suckling, but Halban has pointed out that suckling 

 during pregnancy may indeed induce the secretion of colostrum, but never 

 calls forth the production of milk (cases of Duval and of Hildebrand}. The 



