THE SYMPATHETIC SYSTEM 167 



tumors (carcinoma or sarcoma), sometimes of very large 

 size and complicated by visceral metastasis. These tumors 

 can develop at the expense of the accessory adrenals. 



The ovaries are small, fibrous, full of small cysts. The 

 Graafian follicles and the corpora lutea are few or missing. 



In a recent observation of Tuffier there was atrophy of 

 one ovary and tumor of the other. 



PATHOGENESIS. 



To understand the adrenal origin of these dystrophies 

 it is necessary to recall that the adrenals and the genital 

 organs gave a common embryological origin. 



While the medullary substance of the adrenals arises 

 from the nerve cells of sympathetic ganglia of the superior 

 portion of the abdomen, the cells of the cortex are derived 

 from a covering epithelium of the coelom, which gives birth 

 at the same time to the germinating cells of the testicle or 

 ovary. Tourneux and Mulon have shown that the inter- 

 stitial cells of the genital glands and the cells of the adrenal 

 cortex have an identical histological structure, both contain 

 pigments, lipochromes and phosphated lipoids. 



The experimental researches of Theodosteff have 

 established the fact that the removal of the ovaries in 

 bitches is followed by a hypertrophy of the cortical cells 

 of the adrenals. Raineri has found that the weight of the 

 gland increased four times, a few months after the removal 

 of the ovaries. Bevin observed in a young girl, whose 

 menses had stopped, an adrenal tumor, the removal of 

 which was followed by the return of menstruation. All 

 these facts agree to prove that hypertrophy of the cortex 

 of the adrenal is due to an atrophy of the ovary. 



The hyperfunction of the adrenal cortex, due to a 

 tumor, seems to disturb the development of the sexual 

 characteristics. Coming on at the embryonic period, 



