608 JAMES R. GOODALL 



whole picture 'would seem to be but an exaggeration of the normal changes 

 found in the ovary incident to pregnancy. 



In normal pregnancy, in addition to the development of the corpus 

 luteum of pregnancy, there develops an increase in lutein cells about 

 most of the follicles of ova that have begun to mature. These ova, whose 

 follicular cells become so affected, are doomed to destruction. Under cer- 

 tain ill-defined pathological conditions of pregnancy such physiological 

 development of secretory activity becomes much exaggerated, even to such 

 a. degree as to involve nearly every interstitial cell in the ovary. Notably 

 these changes are found associated with chorioepithelioma of the uterus, 

 and hydatiform degeneration of the placenta. Sufficient study has not 

 yet been brought to bear upon the subject to offer any adequate explanation, 

 though we must look upon such excessive cellular change as pathological, 

 in all likelihood the process is merely temporary. 



Climacteric Changes 



The changes in the ovarian tissue duo to the climacterium are of a 

 physiological nature. The changes are of the nature of sclerosis. In 

 many women the changes become marked very early in sexual life and then 

 become pathological. One might aptly describe it as premature ovarian 

 senility. 



Under such pathological conditions the ovary presents all the char- 

 acters incident to the climacterium. The functional sclerosis of the ves- 

 sels becomes very marked and the destruction and absorption of the prod- 

 ucts incident to reproduction become less and less complete until eventu- 

 ally the ovary becomes filled with thick-walled vessels and corpora candi- 

 cantia. The interstitial cells atrophy and disappear and their place is 

 taken by adult fibrous tissue, except in the cortical third of the ovary 

 where the interstitial cells disappear more slowly than is the case in the 

 medulla of the ovary. 



