242 THE DUCTLESS GLANDS 



majority of these cases occur in female pseudohermaphrodites, 

 that is to say, in females with internal organs of the male type, 

 illustrating the tendency of neoplasia or hyperplasia of the gland 

 to be associated with the appearance of male characters in the 

 female. In most of the females the hermaphroditism was 

 advanced, for prostates were present. Glynn quotes thirteen 

 cases in illustration of this condition. 



Adrenal hypernephromata are almost invariably character- 

 ized in children by precocious growth of the body generally and 

 of the sexual organs in particular, with overgrowth of hair and 

 fat. The skin becomes pigmented and the children are below 

 the average in intellect. According to Guthrie, there are two 

 types : (1) the obese type, met with in both sexes, but apart 

 from the development of pubic hair the development of the 

 sex organs is not exaggerated, though one of the females men- 

 struated ; (2) the muscular or "infant Hercules" type, 

 occurring only in males, who may show true sexual precocity. 



Hypernephromata of the adrenal body in children are much 

 commoner in females than in males, and tend to increase the 

 male primary and secondary sexual characters at the expense 

 of the female. 



Glynn quotes six examples of the tumour referred to in the 

 last two paragraphs. These examples were found in young 

 adult females and the growth was associated with changes in 

 sex characters. It will be interesting to quote one of these : 



A girl aged 16f years began to menstruate at 15, and continued 

 to do so regularly for one year. When menstruation ceased she 

 grew a beard and moustache, and hair developed also on the 

 thorax and linea alba. The voice changed to the male type. 

 She became very obese ; the mammae were well developed. She 

 died of phlegmon of the hand. The external genitals were of 

 the feminine type, the uterus measured 8 centimeters exter- 

 nally and was normal, but the ovaries were small and hard, 

 showing no trace of ovulation, neither macroscopically nor 

 microscopically. The right adrenal contained two yellow 

 nodular tumours the size of a cherry, and the left was con- 

 verted into a mass as big as a fist. Microscopically the right 

 tumour consisted of round or polygonal epithelial cells in a 

 network of capillaries ; those in the left showed similar struc- 

 ture, but the meshes were wider and more irregular. A few 

 larger cells, rich in chromatin and often multinucleated, were 



