ENDOCRINOLOGY IN PEDIATRICS 195 
tion with or without parathyroid. A large thymus is 
responsible for myasthenia gravis, undeveloped geni- 
tals and hypogonadism. This gland is small or absent 
in mentally-deficient and marasmic children. 
Many children regarded as wayward, incorrigible, 
uncontrollable, irritable, precocious, masturbators, sex- 
ual perverts, and who have perverse tendencies, mani- 
fest congenital psychoses, psychophatic personalities 
and show signs of mild or severe forms of mental de- 
rangement, belong to the great group of endocrino- 
pathies or pluriglandular dyscrinisms. We should 
group them according to their physical signs, whether 
they are of thyroid, pineal, pituitary, adrenal, thymic 
or gonad types, or a combination of these, and treat 
them accordingly. We must also include in the the- 
rapy the proper environment, proper diet, good habits, 
sex hygiene, and when necessary, drug adjuvants. 
CONCLUSIONS 
It appears that the ductless glands, which have com- 
mon origin, are related in function, thus adrenalin and 
the posterior pituitary principle have a similar action; 
the anterior lobe of the pituitary body and thyroid ex- 
tract are related in function and origin as also are the 
adrenal cortex and the gonads. 
Metabolic control is governed almost entirely by the 
internal secretaions and, therefore, it plays such an 
important role in children’s disorders during the grow- 
ing period in infancy, childhood and especially at pu- 
berty. The carbohydrate metabolism is primarily reg- 
ulated by the pancreas and adrenals, the former regu- 
lates glycogenic function and the latter glycogenic fixa- 
tion. Protein metabolism is controlled by the thyroid 
gland and the destruction of purin bodies by the hypo- 
physis, epiphysis and the thyroid. Calcium, phosphor- 
ous and mineral metabolism is influenced by the thymus 
and parathyroid. The thyroid, hypophysis and para- 
