384 THE DISEASES OF THE SEXUAL GLANDS 



the menstrual term. Hence seems justified the dictum of W. H. Freund 

 that "labor is a menstruation, in which a fully developed egg is extruded." 

 While, however, the phenomena of the premenstrual period proceed from 

 the ovary, there can be no doubt at all that the similar, but potentized, 

 manifestations of pregnancy proceed from the developed egg. It therefore 

 seems to me that the conclusion lies at hand that all the manifestations of 

 premenstrual period are set free by the maturing follicle, which only renders 

 intelligible the fact that the extirpation of the ovaries during pregnancy has 

 no influence on this phenomenon, as the maturing ovum no longer is found 

 in the ovary, but in the uterus. From this we see that if we ascribe to 

 women an interstitial gland, it can have very little to do with the phenomenon 

 during pregnancy. It takes part in hyperplasia and in increase in function 

 only in the same manner as do the other ductless glands, and the stronger 

 emphasis of many of the so-called sexual characters may stand in connection 

 with it. The most important prevailing alterations of pregnancy are at all 

 events independent of it. 



At the climacteric the interstitial glands show certain regressive changes; 

 they are, however, retained in part, while ovulation ceases entirely. The 

 lipoidemias that Neumann and Hermann observed in postclimacteric women 

 are in my opinion to be referred to the falling out of the function of the fol- 

 licular apparatus. As is known, libido may be retained for a still longer 

 time. The function of the sexual glands is usually associated with an in- 

 crease in the fatty layer of the abdomen and mammae. As is known there 

 occur during the transition period numerous nervous disturbances, that 

 point to extraordinary changing and manifold conditions of excitation 

 in the vegetative nerves. Manifold symptoms of a psychical hyperirrita- 

 bility are added, an existing hysteria becomes worse, and when a predisposi- 

 tion to a psychosis exists this may develop to a climacteric psychosis, which, 

 however, has no specific character (Krajjt-Ebing) . 



We now have to consider the question as to whether the generative ap- 

 paratus in man too possesses an internal secretion. We have already seen 

 that there are clinical observations to the effect that the function of the 

 generative apparatus does not develop (the kryptochides inguinales of 

 Variot) , while the interstitial glands and with them also the masculine habitus 

 are well developed, and that on the other hand similar results have been 

 brought about by experiments. It would now be proper to investigate 

 whether such sterile but otherwise masculine individuals possess the same 

 libido as normal individuals. The cardinal point is the fact whether the 

 developmental disturbance sets in in early youth, or that experimental attack 

 is made on quite young animals. For experience teaches that if once the 

 generative apparatus has been fully developed and has functionated normally 

 then also after complete extirpation of the sexual glands the libido can be 

 retained for a long time. It seems to me important, however, that also in 



