356 HENRY D. JUMP 



navel, making the pubic hair assume the male type. In other words, these 

 women develop male characters at the expense of the female just as is 

 seen in the young girls. 



A. Guemes reports such a case. The patient's age is not given but from 

 the description she appeared, to be about forty-five. Her photograph taken 

 fifteen years before showed her to be of feminine type. Her menstrua- 

 tion, which appeared early, ceased three years before the report was made. 

 The abdomen began to enlarge and she increased in weight (twenty-six 

 pounds in six months). She became stronger, did much hard work and was 

 as energetic as a man : "she feared nothing." The urine showed glucose on 

 one examination. Hair then began to grow in unusual places and con- 

 tinued until, at the time of the report, she had a stiff bristly beard and 

 mustache. The arms were covered with hair. The pubic hair was of 

 the masculine type, extending to the navel. The hair of the scalp was 

 gradually lost until she became partially bald. The voice became of deep 

 tone. Soon after the appearance of the hair she began to waste and grow 

 weak. The breasts shrunk and were covered with dirty wrinkled skin. 

 The skin of the face was dry, wrinkled and the seat of pigmented spots. 

 The neck was thick and muscular and contained pads of fat. The chest 

 was large and emaciated : the abdomen flaccid and pendulous. The clitoris 

 was "exaggerated" and erectile to the slightest touch. There was a recto- 

 cele and a cystocele though she had not borne children. The uterus was in- 

 fantile and the tubes and ovaries impalpable. The thighs and legs were 

 muscular but flaccid and of the conformation of the male. She had a good 

 memory but appeared to be dull : was hypochondriacal. Her height was not 

 increased. She had been married twenty years but had never been preg- 

 nant and had never had normal satisfaction in sexual relations. At the 

 autopsy there were found hypemephroma of the right suprarenal cortex, 

 metastasis to the liver, atrophic and sclerosed ovaries, adenoma of the thy- 

 roid, sclerosis of pancreas and kidneys. 



The syndrome has been observed in cases reported by Alberti and by 

 Zarubin. In one of these the symptoms appeared at twenty and the other 

 at twenty-six after cessation of menstruation. In both the clitoris was 

 enlarged. The former died of an ovarian tumor. The only organs exam- 

 ined at autopsy were the ovaries and uterus. In the other no pathological 

 notes are given. From what we know of such cases it is probable that the 

 suprarenal cortex was the seat of hypernephroma in both of these. 



Hirsutismus 



Hirsutismus is a condition in which there occurs a growth of hair in 

 unusual places in women beyond the age of puberty. It is characteristic of 

 these cases that they retain their feminine attributes. The milder type of 



