LATE EUNUCHOIDISM 419 



only impotence occurs, while libido remains in enfeebled form. In the formes 

 frustes the capability for cohabitation still remains; except that in these cases, 

 as Cordier and Rebattu point out, much stronger stimuli are needed to induce 

 erection. The cremasteric reflexes are either weaker or entirely wanting. 

 Hence the functional disturbance also corresponds entirely with that of early 

 eunuchoidism. 



The same is true for the coloration of the face. The pallor of the face 

 and the delicacy of the skin and body are noted in all cases. There is often 

 found a yellowish tinge; and (in one case) folding of the skin of the forehead 

 (as in eunuchs) . Puffiness of the skin of the face is very rare indeed among 

 the cases reported. 



The hair of the head remains abundant, but as a rule is rather dry. (The 

 cases with patches of alopecia do not belong to pure late eunuchoidism.) 



In severe cases the hair of the body falls out entirely. The mustache, 

 that previously may have been very luxuriant, falls out entirely or at least 

 thins out very much. The same is true of the beard; often is found the state- 

 ment that the patients who previously had to shave several times a week, 

 shave much less frequently. Thinning out of the lashes and the eyebrows 

 does not in'deed belong to the pure picture of this disease. Also the trunk 

 and the extremities may become entirely bald. The axillary hairs, the 

 hairs on the scrotum, the perineum, and on the root of the penis, may fall 

 out altogether. 



Very important for the comprehension of the disease picture are the al- 

 terations of the form. ' As has previously been mentioned, it is in itself sug- 

 gestive that where the beginning of the disease falls at an age where the total 

 epiphysial junctures are closed, a development of the eunuchoidal skeletal 

 type is no longer possible. Of especial importance, therefore, are the observa- 

 tions of Gallavardin and Rebattu, of Cordin and Francillon, and of Stieda. In 

 the first case a youth of eighteen and one-half years old suffered a knock in the 

 scrotal region, and in the second the beginning of the disease lay in the twen- 

 tieth year. In the first case there was only a suggestion of the eunuchoidal- 

 skeletal type (predominance of the lower length over the upper length), and 

 the epiphysial junctions that close at a later period were still open at the 

 twenty-sixth year. In the second case there was a further growth of about 

 3 cm. at the twenty-fourth year. The case of Stieda's sustained a trauma in 

 the fifteenth year of life. He first remained behind in growth and then grew 

 appreciably between the twentieth and the thirtieth years. Here, therefore, 

 the epiphysial junctions had remained open abnormally long. Here also 

 there came about the development of the eunuchoidal dimensions. 



The influence on the weak parts is noted more frequently. In many cases 

 the statement is made that there appeared at the beginning of the disease 

 an adiposity; in other cases that the breasts had become fatty, or the hips 

 rounded, or that the mons Veneris had become richer in fat. In several 



