PATHOLOGY OF THE OVARIES AS ENDOCRIN ORGANS 605 



(1) Those in whom one ovary is developed on one side and a 

 testicle on the other. 



(2) Those in whom there are ovary and testis on one side and 

 either ovary and testis, or neither, on the other side. 



(3) Those in whom there are both ovary and testis on both sides. 



3. Excessive development of ovaries as endocrin organs. The gyne- 

 cologist and pathologist meets with many cases in which the ovaries are 

 abnormally large, greatly scarred, filled with small (so-called) cysts, 

 giving rise to the small so-called cystic ovary. These conditions are fre- 

 quently found in women who have borne many children. Upon care- 

 ful preparation and examination of such specimens one finds that in most 

 of these cases one has to do with ovaries that are functioning much be- 

 yond the normal. The primordial ova are literally packed in a minimum 

 of interstitial tissue, many are in the various stages of development to 

 maturity and many are ready to rupture. The ovarian surface is much 

 scarred by these numerous follicles that have matured and there are cor- 

 pora of all stages of development and degeneration. Every finding points 

 to an excess of reproductive activity with its sequence of increased 

 glandular formation. Stained with Sudan one finds fatty (probably) 

 secretory cells in large numbers scattered throughout the ovaries, 



4. Deficient development of ovaries as endocrin organs. In these 

 the ovaries are small, rather smooth of surface, almond shaped, and with 

 few, if any, visible Graafian follicles. On section, few immature Graafian 

 follicles are seen and few remains of corpora lutea. Primordial ova 

 are rare and the interstitial cells show very few signs of secretory activity. 

 The cause of this and the former defect is probably to be found in heredity. 



Errors Due to Arrested Development 



It is the opinion of the author that many such cases are due to sudden 

 changes in the blood supply of the ovary. In some cases there would seem 

 to have been an arrest of development in the prenatal state whereby the 

 ovary remains fixed in the state of development to which it had arrived at 

 the time of the changed or arrested blood supply. Owing to the sudden 

 vascular change a temporary state of development becomes permanent. 

 In such cases one finds one or both ovaries filled with ducts or solid columns 

 of cells of germinal epithelial origin coursing throughout the ovary, at 

 times cut up into small segments, at other times cystic in character. Not 

 infrequently only a segment of one or both ovaries is so affected. The 

 interstitial tissue in such ovaries or segments of ovaries is sparse and more 

 like adult fibrous tissue. Evidences of secretion and oogeiietic activity 

 in the ovary or portions of ovaries cannot be detected. Not infrequently 

 the fetal rests in such ovaries take on a variety of aberrant growth. 



