EUNUCHOIDISM AND SEXUAL PRECOCITY 435 



these cases; it is possibly often only a secondary phenomenon 

 caused by some other endocrine disturbance. But it is prob- 

 able that if the sex gland has entered into a precocious develop- 

 ment, the latter will lead to a precocious development of sex 

 characters. In some cases tumours of the testicle and of the 

 ovary have been factors. Sacchi's case (quoted from Neurath, 

 1909, p. 71) is instructive. vSigns of sexual precocity became 

 visible in a boy at an age of 6. The left testicle was enlarged, 

 and attained the size of that of an adult man. At the age of 9 

 the boy was 143 cm. high, he had hair on the face, and the 

 sexual organs were extremely large. Now the highly enlarged 

 left testicle was removed. Some months after the operation 

 the signs of sexual precocity disappeared. Instead of the 

 beard, only down was present. The penis was shorter and 

 thinner. The sexual libido, pollutions and erections which 

 were previously experienced ceased. The general psychical 

 behaviour of the boy became more childish. The tumour of 

 the testicle is stated to have been a glandular carcinoma. 

 As to women a number of cases have been described in which 

 sexual precocity was associated with ovarian tumours. Bell 

 (1920, p. 154) holds the opinion that sexual precocity in girls 

 must always be considered in relation to ovarian neoplasm 

 and hyperplasia. Cases have also been recorded in which 

 symptoms of sexual precocity disappeared after removal of 

 the tumour. The relevant paragraph in Bell's book may be 

 referred to here. 



In many other cases tumours of the adrenals have been 

 recorded. The question about the relation between the 

 adrenals and sexual precocity has been lately discussed by 

 Krabbe (1921). He assumes that the cells of the adrenal tumour 

 are by no means normal adrenal cortex cells influencing 

 testicular development, and thereby causing indirectly precocity 

 in the development of sex characters, but that these cells have 

 the same hormonic quality as the hormone-producing cells of 

 the testicle, and directly influence the soma, causing sexual 

 precocity in the male sex. Krabbe argues further that the 

 cases described as "sexual precocity" in woman, as caused 

 by adrenal tumours, are not really such. In these cases a 

 development of the pubic hair and beard or a condition of 

 general hypertrichosis, a great hypertrophy of the clitoris and 

 transformation of the voice into a male-like one have been 



