rregularities are produced. If the disease be present in the
fetus, taking hold before birth, and so brought into the world with
the child, there evolves the condition of pseudo-hermaphroditism. The
individual, if a female, presents to a greater or less extent the
external habits and character of the other sex. So that she is
actually taken for a man, although the primary sex organs are ovaries,
often not discovered to be such except when examined after an
operation or death. How closely such an occurrence touches upon the
problems of sex inversion and perversion comes at once to mind.

If the process involving the adrenal cortex attacks it after birth,
the symmetrical correspondence and harmony of the primary sex organs
and the secondary sex characters are not affected. But there follows
a curious hastening of the ripening of body and mind summed up in the
word puberty, a precocious puberty, with the most startling effects.
A little girl of 2, 3, or 4 years of age perhaps will come to exhibit
the growth and appearance of a girl of 14. She begins to menstruate,
her breasts swell, she shoots up in height and weight, sprouts the
hair distribution of the adult, and the mentality of the adolescent,
restless, acquiring, doubting, emerge. A tot bewitched into puberty!
A boy of six or seven may suddenly, in the course of a few weeks or
months, become a little man, robust, rather short and stocky, but
moustached, with the muscular strength and sexual powers of a man and
thinking as a man. It is all as if into some fermentable medium or
solution a little yeast were dropped that changed the quiet calm of
its surface into a bubbling, effervescing revolution. It suggests at
once that maturation, the transformation of the child into the man or
woman, must be due to the pouring into the blood and the body fluids
of some substance which acts like the yeast in the fermentable
solution. The adrenal cortex is one source of the maturity-producing
internal secretions.

If trouble in the adrenal cortex starts after puberty, phenomena of
the same type, but of a different order, exhibit themselves. A woman,
say in the thirties, becomes thus afflicted. Slowly or quickly her
body will be covered by an abundant growth of hair, more or less of a
beard and moustache appear upon the face, her voice will become deep
and penetrating, her muscles will harden, and she will show a capacity
for hard physical labor. Sexually she appears to be made over,