EUNUCHOIDISM AND SEXUAL PRECOCITY 427 



(c) Acromegalic eunuchoidism, where there is also a patho- 



logical state of the hypophysis; 



(d) Eunuchoid feminism, where the effects are possibly pro- 



duced by heterosexual hormones. 



Furno's classification takes account of the fact that probably 

 only a small number of cases of eunuchoidism are of gonadal or 

 monoglandular origin, the majority being of other or pluri- 

 glandular origin; in these latter cases the hypogenitahsm or 

 underdevelopment of the testicle seems to be caused second- 

 arily by some pathological disturbance in another endocrine 

 gland. It might also be possible that the response of the soma 

 to sexual hormones is changed by some endocrine disturbance 

 without the testicle itself being affected. 



As I have no personal clinical experience I do not wish to 

 dwell longer on these problems. But I think that it must be 

 very difficult to discriminate in individual cases whether the 

 underdevelopment of the testicle is a primary or a secondary 

 one. The underdevelopment of the testicle in a "fat eunu- 

 choid," to use the classification of Tandler, may be primary or 

 secondary, since castration may also lead to the development 

 of a similar type, by interfering with the function of the 

 hypophysis. 



The histological examination of the reduced testicle of the 

 eunuchoid usually shows a degeneration of the generative part. 

 But in some cases complete spermatogenesis may take place 

 temporarily, as many eunuchoids have had children, and 

 eunuchoidism may be hereditary, as was shown by Furno. 



In the development of the interstitial cells there seems to be 

 great variability; they have been described as being present in 

 some cases in normal quantity and in normal condition, 

 whereas in others the interstitial tissue was in a decidedly 

 abnormal condition. The question has lately been studied by 

 Berblinger (1921). He described a man of 26 with certain 

 signs of eunuchoidism. Both testicles were reduced in weight. 

 There was a partial underdevelopment of the seminiferous 

 tubules, but highly developed interstitial tissue. The inter- 

 stitial cells were not only very numerous, forming great masses 

 of cells, but also hypertrophied. Berbhnger concludes from 

 this observation that the interstitial cells cannot play the 

 important endocrine role ascribed to them, since eunuchoidism 



