16 THE GENITAL GLANDS 



such cases. It is of course well known that myx- 

 cedema leads to amenorrhcea and sterihty. 



In cases of pituitary disorder, also, amenorrhoea 

 and sterility are the rule in women, and impotence 

 in men. These are probably due to deficiency of 

 the pituitary secretion, but this is not very clear. 



Not only do the secretions of the ductless glands 

 influence the genital organs, but there is evidence of 

 an effect in the reverse direction. During pregnancy 

 the thyroid gland usually enlarges a little ; in Italy 

 this has been taken for years as a sign of conception. 

 The pituitary gland also shows enlargement (Erdheim 

 and Stumme). Berry points out that adenomatous 

 goitre nearly always occurs in single or nulliparous 

 women. 



It has already been stated that removal of the 

 ovaries is a remedy for osteomalacia ; Bossi has 

 recently advanced evidence that the same effect may 

 be produced more conveniently by injections of 

 adrenalin. 



THE SECRETION OF MILK. 



It is a very striking phenomenon that after twenty 

 or thirty years of quiescence the mammary glands 

 should suddenly spring into activity on the very day 

 when the secretion is required. It cannot be due to 

 nervous influences, because there is no nervous 

 mechanism controlling the flow of milk. For this 

 reason pilocarpine does not increase and belladonna 

 preparations do not check the secretion, in spite of 

 their ancient reputation founded on analogy. It is 

 true that when the child is put to one breast the 



