"Hyperovariap (Dalche) : Precocious pu berty, copious menstruation, pain before and during the first days of the period, intermen strual leucorrhea, developed sexual instinct, well-marked eyebrows, thinness, pallor, small breasts, large pelvis, rounded lower limbs con trasted 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 sec ondary sexual characters, obesity, deficiency of hair, length of the lower limbs, small cranium, 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 infan tilism. (c) Euntichism by castration char acterized by gigantism and infantile appearance. The secondary sexual characters do not appear. (d) The reversive infantilism of Gandy, where simply a sort of asexual condition is noticed, with attenuation of secondary sexual characters and a certain degree of obesity, with late testic ular 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 arterial hyper tension, virile character, activity, moral and physical energy.
Prostate.— Prostatic Insufficiency: Asthenia, diminution of potency, neurasthenia, at times suicide.
Hypertrophy of Prostate: Arterial hyper tension, retardation of the heart, cerebral hemorrhages, genital excitation.
Pluriglandular Basedow's disease with Thymic hypertrophy and vagotonic symptoms; sclerodermia and tetany, amenor rhea• Addison's syndrome; acromegaly, etc.
Myxedematous with Thymic Hypertrophy. Tetany, acromegaly, Addison's syndrome, amenorrhea, infantilism, mammary hypertro phy, 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 Base dowian series.
Ovarian Predominance.—Thyroid Reaction to Ovarian Insufficiency: Tachycardia, palpita.:. tions, perspirations, nervous irritability, vertigo, scanty urination, trembling, anxiety, etc.
The differences between these nervous mani festations and the picture of the attenuated forms of exophthalmic goitre are very slight, says Laignel-Lavastine. This pathogenic con ception permits of important therapeutic results; 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.
Thvro-ovarian Disturbances of the Same Significance.— Either ovarian insufficiency in the myxedematous series, or the dyshyperova rian in the Basedowian series; in either case the nervous disturbances of the dysthyroid are modified by all the factors of the ovarian rhythm, whatever they may be.
Hypophyscal Predominance.— Infantile giants, with their clinical varieties: feminism, eunuchism, cryptorchidism, feminine pseudo hermaphroditism, mental infantilism.
Acromegalics with deficiency syndromes, myxedema, infantilism, amenorrhea, obesity, asthenia.
Acromegalics with syndromes of hyperactiv ity, more or less iciotls, synergetic or substitu tive; simple or exophthalmic goitre, arterial hypertension and atheroma, lacteal secretion.
Suprarenal with amenorrhea, impotence, chilliness, tetany or, on the other hand, exophthalmic goitre.
Very often Basedowians, .acromegalics, 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, skin thickened, wrinkled, pigmented; chilliness, absence of perspiration, asthenia, arterial hypo tension, tetany; testicular, prostatic, suprarenal, thyroidal and perhaps parathyroidal atrophy. Consult Jelliffe and White, 'Diseases of the Nervous System' (3d ed., 1919; chap. III, 'The Endocrinopathies').