THE SYMPATHETIC SYSTEM 241 



lack of external secretion explains the disturbances in 

 menstruation and the sterility (Delbet). A few autopsies 

 have revealed enlarged or diseased ovaries. 



The regression of the mammary hypertrophy is rare 

 and generally incomplete. It is progressive and the 

 severity of the general symptoms necessitates intervention. 

 Ovarian organo therapy being without effect, the only 

 thing to be done is amputation of both breasts which 

 causes, strange to say, a return of the health. 



II. MAMMARY HYPERTROPHY IN MAN. 



(a) It occasionally happens that at puberty in young 

 boys there is a hypertrophy of the breasts which after 

 a time regresses. It looks as if the testicle secreted a 

 cytogenic hormone of the breast, the action of which is 

 inhibited by the ultimate testicular secretion. 



(6) The development of the breasts is frequent in the 

 various syndromes of testicular insufficiency observed 

 after castration or following orchitis with testicular 

 atrophy. It is found in individuals with a poor mus- 

 culature and in which the genital glands are atrophied 

 and with a large pelvis. It, therefore, is one of the 

 elements of feminism. 



(c) Sometimes cases of unilateral hypertrophy are 

 observed in man following a trauma to the scrotum 

 (traumatic orchitis, atrophy of the testicle after a wound 

 of the cord, contusion of the scrotum with hematoma), 

 usually on the same side. It is very hard to explain this; 

 as a rule the traumatism is very slight and does not cause 

 any atrophy of the gland and that, furthermore, uni- 

 lateral castration or a diffuse glandular destruction does 

 not cause gynecomastia. 



(d) Hyperplasia of the mammary gland is also some- 



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