3QO THE DISEASES OF THE SEXUAL GLANDS 



away with the problem altogether. Before all, however, we should think of 

 the possibility that the sexual glands actually give off the formative stimulus 

 for many a sexual character, especially if we take the viewpoint that some of 

 the sexual characters come under the dominating influence of the interstitial 

 glands, others under those of the generative glands. I have previously set 

 forth that if we ascribe to women an independent function of the interstitial 

 and the generative glands, the development of the mammary glands seems to 

 stand only under the formative stimulus of the follicular apparatus or of 

 the ovum. From this standpoint it is worthy of note that Steinach in his 

 experiments transplanted not only the interstitial glands but also the follicu- 

 lar apparatus. We can readily imagine that the interstitial glands alike, 

 whether they come from man or woman, exercise the same protective stimulus 

 on certain preexistent masculine or feminine sexual characters; but no one 

 would expect the same action from the masculine as from the feminine gen- 

 erative glands. 



Finally we should think of the possibility that the development of many 

 of the sexual characters comes entirely or partially under the influence of 

 other ductless glands. A new viewpoint has lately opened in this direction, 

 a viewpoint that also seems adapted for showing the occurrence of many 

 a heterosexual character in a new light. I refer to those observations that 

 were described in detail in the consideration of tumors of the suprarenal 

 cortex. Women who have developed entirely normally up to or beyond the 

 age of puberty become, on the development of such a tumor, amenorrheic; 

 the uterus atrophies, and there develops a hypertrichosis. Mustache and 

 beard grow, and hairs on the trunk become abundant; in short, the distri- 

 bution of hair assumes quite the masculine type. The supposition that this 

 heterosexual hairiness is to be referred to a hyperfunction of the suprarenal 

 cortex is very probable, suggesting the thought that also in the virile type 

 of hairiness that is observed in acromegalic -women, or even in normal women 

 during pregnancy there is the same cause for hyperplasia of the suprarenal 

 cortex is observed in both conditions. 



Why, however, do we find, in those cases in which the suprarenal tumor 

 develops in earliest youth, a premature development of the genitalia with 

 marked accentuation of the sexual characters without reversal to the hetero- 

 sexual type, while, when it occurs in women who are already matured, the 

 activity of the sexual glands fails? In explaining this fact I would refer once 

 more to the relations in acromegaly. Here, in addition to marked accen- 

 tuation of many sexual characters, in addition to the masculine type, we 

 find either, mostly only temporary, increase of the activity of the genera- 

 tive gland (even with secretion of colostrum) or, what is more frequently the 

 case, the failure of this from the beginning. In this there seems to me to 

 lie an analogy with the behavior of the generative glands in tumors of the 

 suprarenal cortex; we may assume that hyperfunction of the suprarenal 



