240 ENDOCRINE GLANDS 



enormous sacs, which fall as far down as the umbillicus 

 and even in some cases to the level of the knees. This 

 mammary hypertrophy has no ganglionic reaction. There 

 is no secretion from the breast. There is at first a sensa- 

 tion of discomfort, then fatigue. The patients are 

 smothered and have considerable difficulty in breathing. 



This condition is not only a deformity but cripples the 

 patient. It brings on severe general symptoms that the 

 volume of the breast alone could not explain. These 

 patients emaciate, become pale, have gastro intestinal 

 disturbances, often diarrhea and die, either from some 

 intercurrent affection or from a local complication: 

 abscess, gangrene, fibroma, or cysts. In these girls the 

 menses do not appear or are irregular and painful. If 

 menstruation has already set in it disappears. Pregnancy 

 is the exception and rarely goes to term. 



In a few cases the condition is unilateral : 



The histological examination of the gland, does not 

 reveal any tumor or abnormal formation. Its structure 

 is that of a normal gland in which the lobes and the peri- 

 glandular tissue is abundant without any histological 

 changes. According to Caubert, it is a "gigantism of 

 the breast." 



The pathogenesis is still obscure. We know that the 

 condition is often hereditary. 



Because this condition appears at the time of puberty 

 Pasquier believes that it is due to a disturbance of the 

 ovary and perhaps to an excess of internal secretion. The 

 resorption of the ovules, particularly pronounced at pu- 

 berty, results in decrease in the external secretion of the 

 ovary; that is, ovulation at the expense of the internal 

 secretion and this is equivalent to a resorption of toxic 

 substances, which results in severe disturbances. The 





