THE THYROID-OVARIAN SYNDROME 97 
in whom sexual life is still active, and represents the 
condition known as hypo-ovarism. It may last for from 
two to five years before merging into the fully devel- 
oped syndrome. 
As illustrative of the condition, the histories of three 
cases are briefly cited: 
Case I. A married female, 38 years of age, with a 
negative past and family history, and who had had 
three normal children after uneventful labors, pre- 
sented herself with the complaint of severe backache 
and weakness. She had previously been treated for 
flat feet, varicose veins, relaxed abdomen, a relaxed 
sacroiliac joint, an arthritis and a supposedly relaxed 
perineal floor—all without result. The onset of symp- 
toms dated back three years, and was gradual. At 
first, the backache was intermittent; later, continuous 
and typical. Menstruation at the onset of the back- 
ache had been freer than usual, latterly it was scanty 
and the periods were irregular and from two to three 
weeks late. Her weakness dated back four months, 
and could not be attributed to any intercurrent in- 
fection. 
It may be said here that in all the cases reported 
here the physical examination included a complete sero- 
logical, cytological, and chemical] examination of the 
blood, a complete examination of the urine and feces, 
and an exhaustive physical examination, including the 
organs of special senses and the nervous system. Physi- 
cal and laboratory examinations were negative except 
as stated below. 
The patient was 15 pounds overweight; there were 
slight hirsuties on the chin; the abdomen was pendu- 
lous and supported by a belt; there were slight super- 
ficial varicosities on the lower legs; and the perineal 
floor was relaxed. The pelvic organs showed no other 
demonstrable lesion. 
