INCOMPLETE PUBERTY 159 



infantilism ', the patient may remain under-developed Sexual 

 in every respect, and the absence of sexual development a1 

 is merely part of the general infantilism, as we have 

 already seen. It is probable, then, that certain hormones 

 arising from the hormonopoietic system, "which normally 

 stimulate growth and development, are suppressed or 

 are insufficient. 



At the present time our knowledge is not definite 

 enough to enable us to lay down specific lines of treat- 

 ment in cases in which the patient remains infantile, 

 except, perhaps, in those cases in which there is pan- 

 creatic infantilism. Yet even now a careful examina- 

 tion of any individual case may enable us to improve 

 the condition of the patient, if we can trace it to 

 the imperfect action of one of the organs of internal 

 secretion. 



Incomplete Puberty. By ' incomplete puberty ' is incomplete 

 meant that the girl arrives at puberty with all her adult P 

 secondary characteristics fully developed, but that her 

 genital functions are permanently in abeyance. This 

 may occur as the result of : 



(1) Incomplete or incomplete and imperfect develop- Conditions 

 ment of the whole or part of the genital ducts, with 

 normal ovaries. 



(2) Incomplete development of the ovaries and genital 

 ducts, with or without imperfect formation of the whole 

 or part of the ducts. 



(3) Constitutional disturbances. 



With regard to the first condition, which is very 

 common, we usually find that the parts forming the 

 genital ducts Falloppian tubes, uterus and vagina 

 are perfectly formed but that the uterus is infantile, and 

 that in consequence menstruation does not appear. 

 We are not concerned, however, with the malformations 

 as such, but only in so far as they affect the genital 

 functions. 



It is, of course, not always easy, without histological 

 examination, to be certain that the ovaries of any given 



