eHyperovariae (Dalche) : Precocious puberty, copious menstruation, pain before and during the first days of the period, inter menstrual leucorrhcea, developed sexual in stinct, well-marked eyebrows, thinness, pallor, small breasts, large pelvis, rounded lower limbs contrasted in size with the upper ones, arterial hypotension, craving for movement and action, enervation, tendency to loquacity, erotic crises.
Testicles.—Infantilism: Defective develop ment of the male genital organs, absence of secondary sexual characters, obesity, deficiency of hair length of the lower limbs, small cra nium, childishness.
Acquired Testicular Insufficiency: Increase in height, diminution of the pilous system, glabrous state of the body, tendency to obesity, gynecomasty, frigidity, impotency, senility, arterial hypertension( ?), asthenia.
The types of testicular insufficiency accord ing to Rebattus and Gravier are: (a) The sterile. (b) Eunuchoid gigantism, because the internal secretion of the testicle is established late. In this case there is a prolonged infantil ism: (c) Eunuchism by castration character ized by gigantism and infantile appearance. The secondary sexual characters do not appear. (d) The reversive infantilism of Gandy, where simpbr a sort of a sexual condition is noticed, with attenuation of secondary sexual characters and a certain degree of obesity, with late testicular difficulty in the adult.
Dyshyperdiastematia: Lower limbs short and cranium very large, pilous system well de veloped, especially the mustache, thinness, per sistence of youth, a degree of artenal hyperten sion, virile character, activity, moral and physi cal energy.
Prostate.— Prostatic Insufficiency: Asthenia, diminution of potency, neurasthema, at times suicide.
Hypertrophy of Prostate: Arterial hyper tension, retardation of the heart, cerebral hemorrhages, genital excitation.
Pluriglandular Syndromea—Baseilow's dis ease with thymic hypertrophy and vagotonic symptoms; scleroderma, and letany, amen orrhea, Addison's syndrome; acromegaly, etc Myxedematous with Thymic Hypertrophy: Tetany, acromegaly, Addison's synd:ome, amenorrhcea, int antilism, mammary hyper trophy, etc.
Acromegalic or ovarian insufficiencies with various disturbances, psychic, nervous, vaso motor, trophic, etc., connected at one time with the myxedematous, at another with the basedowian series.
Ovanun Predominance.— Thyroid Reaction
to Ovarian Insufficiency: Tachycardia, palpita tions, perspiration, nervous irritability, vertigo, scanty urination, trembling, anxiety, etc.
The differences between these nervous manifestations and the picture of the attenuated forms of exophthalmic goitre are very. slight says Laignel-Lavastine. This pathogenic con ception permits of important therapeutic re sults; one may ask, for example, whether the anti-basedowian therapy with hematothyroidin would not be of advantage in the nervous and psychic disturbances of the normal menopause which repeat one feature after another of the basedowian series.
Dyshyperovaria of the Hypothyroid: Antici pation, prolongation and copiousness of the menses, menorrhagia, metrorrhagia.
Thyro-ovarian Disturbances of the Same Significance.— Either ovarian insufficiency in the myxedematous senes, or the dyshypero varian in the basedowian series; in either case the nervous disturbances of the dysthyroid are modified by all factors of the ovarian rhythm, whatever they may be.
Hypophyseal Predominance.— Infantile giants, with their clinical varieties: feminism, eunuchism cryptorchidism, feminine pseudo hermaphroditism, mental infantilism.
Acromegalics with deficiency syndromes, myxedema, infantilism, amenorrhcea, obesity, asthenia.
Acromegalics with syndromes of hyperactiv ity, more or less vicious, synergetic or substitu tive: simple or exophthalmic goitre, arterial hypertension and atheroma, lacteal secretion.
Suprarenal. Predominance.—Addisonian with amenorrhcea. impotence, chilliness, tetany or, on the other hand, exophthalmic goitre.
Very often basedowians, acromeicalics, giants, with spontaneous glycosuria, alimentary or merely adrenal, the latter making it possible in certain cases to suppose a certain degree of suprarenal hyperactivity.
Without Marked Predominance.— The case of Claude and Gougerot is an example: Loss of sexual characters, countenance old-looking, slcin thickened, wrinkled, pigmented; chilliness, ab sence of perspiration, asthenia, arterial hypo tension, tetany; testicular, prostatic, suprarenal, thyroidal and perhaps parathvroidal atrophy. Consult Jelliffe and White, 'Diseases of the Nervous System' (Chap. III, °The Endocrino pathies") ; Eppinger and Hess, (Vagotonia, Nervous .and Mental Disease' (Monograph Series, No. 20, New York).