76 INTERNAL SECRETION 



An oestrum 



Pro -oestrum (uterine degeneration) 



I 



(Estrus (ovulation) 



Pregnancy 



| Metoestrum 



Nursing period 



Anoestrum 



In males, as we have seen, interference with the discharge of 

 the seminal fluid has no effect on the secondary sexual charac- 

 ters, while removal of the testis has a very marked effect. 

 Similarly in the female, any operation which abolishes the 

 normal passage of the ova down the Fallopian tubes into the 

 uterus has no influence on the secondary characters, while re- 

 moval of the ovary results in the changes about to be described. 



Our knowledge of the effects of extirpation of the ovaries 

 before the age of puberty in the human subject is very limited. 

 A fairly large number of operations must have been performed 

 in which female children were deprived of both ovaries at an 

 early age, but there seems to be no systematic account of them. 

 Marshall states that such extirpation, if the operation be 

 carried out before puberty, besides preventing the onset of 

 puberty and the occurrence of menstruation, produces notice- 

 able effects on the general form and appearances. He instances 

 the case of certain adult women in semi-barbarous parts of 

 Asia, where the natives perform this operation upon young 

 girls. Such women are said to be devoid of many of the 

 characteristics of their sex, and in certain cases to present 

 resemblances to men. This account seems to be derived from 

 the observations of Roberts in the East Indies. According to 

 Biedl, however, there is no ovariotomy among such people, 

 but simply a mutilation of the external organs of generation. 

 Indeed, it seems incredible that savages could successfully 

 perform double ovariotomy. 



When extirpation of both ovaries is carried out in the human 

 female after the age of puberty, the most marked effect is the 

 cessation of menstruation. There is also in some cases an 

 atrophy of the uterus, vagina, and external genitals. The 

 effects on the breasts vary in different cases. Sometimes these 



