192 THE INTERNAL SECRETIONS 1920 



uterine decidua and the fixation of the embryo. Be- 

 cause of these, I usually employ this gland in treating 

 tardy menstruation, and when I suspect by reason of 

 undue adiposity, delayed menses and small external 

 genitals, the condition of atrophy of the uterus or ova- 

 ries in young girls. 



In hypogonadism the children increase in weight, the 

 skeletal bones are large, and the head is small. There 

 is a tendency to glycosuria and adiposity. Again, in 

 others we may see an essential infantilism with defec- 

 tive development of the genitals and secondary sexual 

 characteristics. In the male the development of the 

 genital organs is controlled by the interstitial cells of 

 Leydig, but are secondarily affected by the pituitary, 

 thyroid, pineal, thymus and the adrenal cortex. The 

 treatment of these cases depends upon the presence of 

 the other physical signs associated with the hypogonad- 

 ism. I have used various forms of organotherapy in 

 these cases with much success. 



In hypergonadism there is an enormous overdevelop- 

 ment of the body, excessive growth of hair and distribu- 

 tion, and the libido-sexualis is developed as in adults. 

 Van Haller reports a case in a girl of this type, who 

 was impregnated at 8 years of age, shortly after this 

 abnormal growth showed itself, and who died at the 

 age of 75 years. The intelligence is well-developed, but 

 childish, the voice is prematurely changed and erections 

 and ejaculations have been noted even in infancy. In 

 these cases the excessive development of the genitals 

 precedes the overdevelopment of the body. As a result 

 of this premature closure of the epiphyses is brought 

 about and these children, although too big for their age, 

 cannot become giants. They are, as a rule, sexual per- 

 verts. Malignant disease of the ovaries or testicles 

 may give rise to this condition. In females we get over- 

 development of the breasts, uterus and vulva, men- 

 struata praecox, excessive body-growth, with prema- 



