LATE EUNUCHOIDISM 413 



youth with left-sided inguinal cryptorchidism and obesity; under thyroidin 

 treatment the genitals took on a rapid development. 



There is no doubt that we are often able to improve with thyroidin the 

 fat types of obesity. Thus for example in Observation Sch, there occurred 

 without limitation of diet, after the administration of even small doses of 

 thyroidin, a rapid reduction of 3 kg. in weight. A considerable improvement 

 is also reported by Lemos Magelhaes. In a case of adipositas nimia who 

 weighed 160 kg. there occurred under thyroidin treatment a reduction of 32^ 

 kg. Then intoxication symptoms appeared. I do not feel justified, however, 

 in referring offhand, as do Apert, Parhon and Mihailesko, the improvement 

 in the genital sphere to the thyroidin treatment, or in constructing, because 

 of the improvement, an etiological connection. To me the reports do not 

 seem convincing that these cases were cured by thyroidin, because as has just 

 been mentioned, there have been sometimes observed in this growth period 

 improvements that are spontaneous. But we must accept a certain stimu- 

 lating action of thyroidin. 



Not much has been reported as to other methods of treatment. I do not 

 know that extracts of sexual glands have been used. As radium emanations 

 have a certain stimulating action on the sexual glands Freund and / saw 

 several times through radium treatment an increase of the potency, a re- 

 currence of the periods at the climacteric or an aggravation of dysmenorrheic 

 complaints in one case (Observation Sch) I used the radium emanation, 

 perhaps with good results. Such a result is to be expected only in youthful 

 cases. In another case (Observation H, twenty-eight years old), who on 

 account of his joint affection was treated for a long time, all action on the 

 sexual glands remained absent. 



The transplantation of the sexual glands has not to my knowledge been 

 tried in the treatment. 



4. Late Eunuchoidism 



Historical. The first excellent description of this disease we find in 

 Larrey in his " Campagne d'Egypte : de 1'atrophie des testicules." Larrey ob- 

 served in several soldiers who had followed the campaign in Egypt with 

 Napoleon and later, in soldiers of the Imperial Guard, simultaneously with 

 gradually occurring atrophy of the testicles with retrogression of the penis, 

 disappearance of the libido and the potency, falling out of the pubic and ax- 

 illary hairs, development of a falsetto voice, and certain alterations of intelli- 

 gence and psyche. Larrey sees the cause of the disease in the deleterious in- 

 fluences of the climate, or in sexual abuse or in alcoholism. Lately interest 

 has again been turned toward this subject by Gandy who described three 

 cases, that he termed infantilism reversif ou tardif. Of Candy's cases I 

 would regard two as typical cases of late eunuchoidism. The third belongs 

 to multiple ductless glandular sclerosis. Gandy seeks the cause of the 



