184 THE SEX-COMPLEX 



Effect of the nervous and muscular irritability, which are constant 



excessive 

 ovarian 



features of these cases. In pregnancy and lactation, 

 th Cretl( T ° n nowever > there is a large demand for calcium over and 

 boiism. above the amount necessary for the normal maternal 



metabolism, and, as a result, softening of the bones may 

 occur. This condition is known as osteomalacia. 

 Osteomalacia. Osteomalacia is not common in England, but is more 

 frequently encountered in other countries such as Italy, 

 Austria and India. The disease used to be treated by 

 removal of the ovaries, and many patients were cured. 

 Figure 61 is of a section of an ovary, which was greatly 

 enlarged, from a case of osteomalacia. It will be seen 

 that the interstitial cells are very prominent, much more 

 so than in normal ovaries during pregnancy. 

 Hyperplasia Wallart 1 was probably the first carefully to examine 



ceiistrf titial the ovaries in this disease by histological methods. 

 osteomalacia. The ovaries from five cases are described. In four the 

 interstitial cells were particularly well developed. More- 

 over, he states that this is always so in osteomalacia, 

 whether the patient be pregnant or not ; and he agrees 

 with Bossi 2 that osteomalacia is due to vasodilatation, 

 which affects the vessels of the bone-marrow as well as 

 those of other tissues. 

 Suprarenin Some years ago Bossi 2 of Genoa suggested the 



bulin in injection of suprarenal extract as an alternative to 



treatment of oophorectomy ; and apparently manv cures have been 



osteomalacia. r J ' rsr J J 



effected by this treatment. I have also suggested 

 treatment with injections of infundibular extract, and 

 Miss Kate Knowles, of Srinagar, Kashmir, working in 

 conjunction with me, has found that infundibulin is 

 most beneficial in a number of cases of this disease. 



It may, therefore, be argued that there is insufficiency 

 in the suprarenals and pituitary as well as an excess of 

 ovarian secretion ; and this, indeed, is quite possible. 

 On the other hand, it may be suggested, as has been 

 done by Bossi and Wallart, that the general vasodilatation 

 caused by hyperplasia of the intestitial cells is a primary 



1 Wallart, J., Zeitsch.f. Gel. u. Gynah, 1908, vol. fad, p. 581. 



2 Bossi, L. M., Centralbl. /. Gyriak., 1907, vol. xxxi, p. 69. 



