414 THE DISEASES OF THE SEXUAL GLANDS 



affection chiefly in a dysthyroidism, while Claude and Gougerot describe a 

 series of cases that they refer to an insuffisance pluriglandulaire endocrinienne. 

 Cordier and Rebattu treat the subject in a large study of these cases; they 

 again uphold the designation " inf antilisme regressif type Gandy," 



Recently I have published a study on this subject in which I pointed out 

 that the manifestations in this disease, so far as they connected with the 

 genitals, are like those of eunuchoidism; and I selected from the group the 

 pure cases of "late eunuchoidism" [" Spateunuchoidismus "] from late eu- 

 nuchoidism which is only the partial manifestation of a very complex clinical 

 picture. 



Definition. / term "late eunuchoidism" a clinical picture that comes about 

 by the fact that in an already matured organism in which also the functions of the 

 sexual glands have attained their full development, there occurs atrophy of 

 the accessory genital apparatus (in man retrogression of the penis, scrotum, the 

 prostate, etc.; in woman the labia major a and, the uterus), and, retrogression of 

 the secondary sexual characters (mustache, beard, hairiness of the axillce and the 

 pubis, the trunk and the extremities}. Moreover there develop more or less 

 distinct collections of fat on the breasts, the mons Veneris, and the hips, and 

 often certain alterations of the psyche. The typical eunuchoidal alterations of 

 the skeleton can no longer go on developing, especially where the develop- 

 ment of the skeleton has been already closed off; that is where the epiphysial 

 junctures have already united. 



There is regularly found a high-grade affection of the sexual glands, that must 

 be regarded as the cause of the manifestations described. 



Case Reports. I have already treated in my publication the case histories 

 of this affection somewhat in detail. Since the time I wrote my article I have 

 found still more cases in the older and newer literature. As I would describe 

 the clinical picture in detail and delimit it as precisely as possible, I will here 

 make a complete report of the case histories. Then I shall classify the cases 

 according to their etiology, as nearly as possible. Moreover, I would here 

 state that the position of a series of cases is still uncertain. I shall come back 

 to these cases in the consideration of multiple ductless glandular sclerosis, 

 and here set forth only those cases which I regard as pure cases of late eu- 

 nuchoidism or at least as cases in which the manifestations of late eunuchoid- 

 ism stand quite in the foreground. 



A. Cases that depend on a traumatic foundation. 



Observation of A chard and Demanche. Sixty-eight-year-old man. Pale tinge, the 

 skin of the entire body pale and dry. Hair of head abundant, skin of the face and trunk 

 and extremities completely bald. Eyebrows sparse. The breasts not essentially enlarged. 

 The scrotum small, both the testicles small, the cremasteric reflexes very weak. Intelli- 

 gence normal. Easily excitable disposition; at the twenty-fifth year of life, the man had 

 sustained an injury, due to the tread of a foot, in the scrotal region. The testicles had be- 

 come swollen, as the result of the injury, and later atrophied. Beard and cranial hair, 



