ENDOCRINOLOGY IN PEDIATRICS 191 
ism in twins I reported recently, I began to treat them, 
by suggestion of Dr. Harrower, with thymus, thyroid 
and anterior pituitary extracts, and there is evident im- 
provement in their general growth and intelligence. 
In the treatment of infantalism, due to cretinism, 
pancreatic insufficiency (Bramwell type), chronic 
diarrhea and syphilis, we get good results from the 
specific treatment of the respective underlying causes. 
In acromegaly we may, at times, observe the abnormal 
processes of bone growth, chiefly of the face and ex- 
tremities in young children. This is, however, not con- 
spicuous until after puberty. Gigantism occurs earlier. 
The Froehlich, Burnier and the Cushing types include 
all the possible acromegalic or dyspituitary changes. 
The symptom-complex here consists of skeletal over- 
growth, a highly sensitive sympathetic system, exces- 
sive sexual development—often to precocity in chil- 
dren—excessive hair growth and distribution, and re- 
duced carbohydrate tolerance. Hyperpituitaric indi- 
viduals are irritable, bright but distrustful, petulant, 
indecisive, abusive and unreliable. This condition is 
often associated with syphilis and, therefore, a Wasser- 
mann test should be made in every case. I have gotten 
good results from the use of various pluriglandular 
formulas. 
ANOMALIES OF THE SEX GLANDS AND REPRODUCTIVE 
ORGANS 
Gonad disturbances are associated with dysfunction 
of any or all of the internal secretary glands. There 
seems to exist a reciprocal relation between the thymus 
and the reproductive glands. Atrophy of one causes 
hypertrophy of the others. (Henderson.) Experi- 
mental evidence seems to point to the fact that the 
formation of the corpora lutea leads to the develop- 
ment of the mammae, secretion of milk and hyperplasia 
of the uterus. Its chief function is the formation of the 
