THE THYROID-OVARIAN SYNDROME 95 
The thyroid gland is concerned chiefly with catabolic 
metabolism, hyperfunction resulting in rapid loss of 
weight, hypofunction in adiposity. In addition to 
changes in metabolic activity, dysfunction is also mani- 
fested by various nervous symptoms, hyperfunction by 
excessive nervous irritability, hypofunction by mental 
sluggishness. The functions of the ovary are by no 
means as clearly manifested. One obvious function of 
that organ is the production of ova, and another much 
less understood function is that of the control of the 
secondary sexual characteristics. This function is to 
some extent controlled by the interstitial chroma- 
tophilic cells and these probably are similar in charac- 
ter to the interstitial cells of Leydig found in the testes. 
The thyroid-ovarian syndrome is a “forme fruste” of 
dysfunction either of one gland individually, or of both 
glands concurrently. Isolated phases of the syndrome 
have been described as clinical entities, but as far as a 
thorough search of the literature reveals, no one has 
grouped the various symptoms as a distinctive syn- 
drome. 
Strangely enough, the syndrome may occur in either 
male or female, though the female was affected in 
forty-one of the forty-five cases which we have thus far 
observed. In the male, testicular dysfunction replaces 
dysovarism. The onset of symptoms may be at any 
period after the beginning of puberty, the age incidence 
in the present series being twenty to thirty years, five 
cases; thirty to forty years, sixteen cases; forty to 
fifty years, twenty cases; fifty to seventy years, four 
cases. No etiological factor other than the possible 
influence of heredity is in evidence. Sister, or sister 
and brother, were affected in twenty instances, while 
in eight other cases near blood relatives, 7. e., mother, 
were said to be similarly diseased, though these eight 
have not been personally examined. 
