350 HENRY D. JUMP 



metastases in the liver and lungs. The uterus and ovaries were enlarged 

 and the latter showed corpora lutea: the thyroid and parathyroids were 

 hypertrophied ; no note is made of the condition of the pituitary and pineal 

 bodies. She became fat after menstruation appeared : was 54 inches tall 

 and weighed 87 Ibs. The skin was dark but not pigmented in patches. 

 There was a profuse growth of hair on the lip, chin, axillae and pubis. 



Reversive sexual changes have been noticed in adults suffering from 

 tumor of the suprarenal cortex. A. Guemes reports a case of a woman who 

 had a hypernephroma of the right suprarenal cortex and atrophy of the 

 ovaries. Her menstruation ceased early and later she grew a beard. A. 

 Bittdorf (c) saw a man of 26 in whom a hypernephroma of the suprarenal 

 cortex was followed by diminution of the sexual desires, atrophy of the 

 testicles and enlargement of the breasts of the female type. 



Feeding experiments with this gland have been done by R. G. and 

 A. D. Hoskins. They used white rats with proper controls and fed the 

 animals for two to nine weeks. In them there were found hypertrophy 

 of testicles and ovaries. 



I am then inclined to the belief that the suprarenals act as controllers 

 of sexual development. They receive inhibitory or acceleratory influ- 

 ences from the pineal, pituitary gland and thymus. 



Gonads 



Neurath has collectected five cases of precocious puberty associated 

 with tumors of the ovaries or testes. Since his monograph there has been 

 at least one more, that of Harris. In this case the removal of an ovarian 

 teratoma caused a cessation of the precocious growth and menstruation. 

 In Riedel's case the removal of a sarcoma of the ovaries was followed by 

 a cessation of menstruation. One case of tumor of the testicle associated 

 with precocity is found, the frequently quoted one of Sacchi. This boy 

 grew rapidly until at 9 he weighed 44 kg. (97 Ibs.) ; had hair on the lip, 

 and genitalia; voice deep, penis large, frequent erections and seminal 

 emissions. An alveolar carcinoma of the left testicle was found and re- 

 moved. After four months the hair on the chin had disappeared ; that 

 on the lipi and pubes persisted, the voice became childlike, the penis less 

 large, erections and emissions ceased. 



The testes consist of two tissues, the interstitial cells of Leydig and 

 the seminiferous tubules of Sertoli. The former seem to be most con- 

 cerned with the development of the external secondary characteristics: 

 the latter with the development of sexual maturity. One or the other or 

 both may show signs of development with consequent bodily changes. 

 In precocious puberty it is reasonable to presume that both are developed. 

 Such elements in the ovary are not differentiated but from analysis it 



