358 THE DISEASES OF THE SUPRARENAL APPARATUS 



the childish organism there occurs an enormously accelerated development of 

 the body, a premature development of the genitalia. Such cases are described 

 by Cooke, a seven-year-old female ; Tilesius, a 'four-year-old female ; Ogle, a 

 three-year-old female; Calcott-Fox, a five-year-old female; Orth, two and 

 one-half-year-old female ; Dobbertin, four-month-old female ; Ritsche, four-year- 

 old female; Bullock and Sequeira, eleven-year-old female; Linser, five-and- 

 one-half-year-old male; Adams, fourteen-and-three-fourth-year-old male. 

 In the case of Adams, puberty set in at the age of ten years. The boy was 

 large and strong muscularly. Autopsy showed tumor of the left suprarenal 

 proceeding from the cortex. A careful compilation of the literature has been 

 made by Neurath, and more recently by Glynn. Further cases are reported 

 by Guthrie and W. d'Este Emery (four-and-one-half-year-old boy, fat, large 

 tumor of the suprarenal cortex) , by Richards (seven-year-old girl) , by Glynn 

 and by French (reported by Glynn) ; and perhaps also the case of Guinon 

 Bijou belongs here (no autopsy). 



Some cases I shall quote more exactly. The case of Linser was that of a 

 five-and-one-half-year-old boy, who looked like a youth and therefore was 

 admitted into the men's department of the hospital. He was 138 cm. tall, 

 the penis was 8-9 cm. long, the testicles as large as pigeon's eggs, the pros- 

 tate like that of a fifteen-year-old boy, the musculature was well-developed. 

 The size of the body, the ossification, the almost complete set of permanent 

 teeth, corresponded fully to those of a fifteen-year-old boy. The upper 

 length was larger than lower length, hence childish dimensions were present 

 in a potentized form. The hypophysis was normal and there was adiposity. 



The case of Bullock and Sequeira was of an eleven-year-old female who 

 looked like a forty-year-old woman. Menstruation had set in at the age of 

 nine and three-fourth years and from this time on there developed an in- 

 creasing adiposity. The girl was 4 ft. 6 in. high and weighed 6 stones, 3 Ib. 

 [87 Ib.]. The breasts were fully developed. Long hairs were present on the 

 genitalia. Autopsy showed a large tumor of the left suprarenal consisting 

 in cells of zona fasciculata, with numerous metastases, hyperplasia of the 

 thyroid and the parathyroids, fully developed uterus and large ovaries with 

 corpora lutea of recent date. 



The case of Richards was that of a seven-year-old girl. At the age of 

 five she developed pubic hair and hair on the face. At seven years old she 

 looked like a woman twenty years old, the hairs on the genitalia were fully 

 developed, and hairs were present on the side of the face and on the site of 

 the mustache. 



The case of Glynn was that of a girl five years old. In the third year of 

 life she began with pains in the abdomen and the head, later apathy. She 

 was as large as a girl fourteen years old, and fat. Hairs were present on 

 the upper lip, on the pubis and on the back. The sexual organs were espe- 

 cially well developed. There was found a large tumor of the suprarenal 



