LATE EUNUCHOIDISM 421 



behavior in these respects is not always as clear as in operative myxedema. 

 It should, however, be considered that the disease process that in this con- 

 dition is responsible for the sclerosis of the thyroid gland very readily and 

 very often involves other ductless glands, and that here we are no longer 

 dealing with mere action at the distance. 



Can we show by experimentations the significance of the sexual glands 

 for this clinical picture in a clean and clear-cut fashion? To answer this we 

 must have recourse to the known experiments of A ncel and Bouin. In 

 male grown animals the ligation or transection of the vas deferens, or patho- 

 logical stenosis of the exit-ducts of the sperm, leads to degeneration of the 

 germinative part of the sexual glands, while the interstitial substance is 

 retained. The animals become sterile but they are not impotent, and retain 

 their masculine appearance. If, however, the " interstitial glands" are 

 brought to degeneration the animals lose their masculine appearance and 

 become similar to castrates. In this manner there is therefore produced an 

 experimental late eunuchoidism. I refer moreover to late castrates whom I 

 have described above. The same value for the pathogenesis is afforded by 

 the very numerous cases of pure traumatic late eunuchoidism; they show that 

 severe injuries of the male genitalia may lead to the full symptom-complex of 

 late eunuchoidism; also in these cases there does not exist the slightest basis 

 for regarding the condition as a primary affection of the other ductless 

 glands. The question as to whether the loss of both sexual glands leads 

 regularly to the development of late eunuchoidism does not seem to me en- 

 tirely solved by the material up to the present time, although I regard it as 

 very likely. Widal and Lutier have reported a case with marked testicular 

 atrophy, in which the manifestations of late eunuchoidism did not seem to be 

 present. Cordier and Rebattu discuss the possibility whether in these cases 

 there were still present functionally capable islands of Ley dig's interstitial 

 cells or ectopic sexual glandular tissue. 



Much less clear are the alterations in women. That premature meno- 

 pause and hyperinvolution of the uterus through repeated births or pro- 

 longed lactation does not lead to any change in the secondary sexual char- 

 acters is readily intelligible, as there need not be .associated with the retro- 

 gression of the follicular apparatus a retrogression of the interstitial substance. 



On the contrary it is really not intelligible why the loss of the whole 

 ovaries exercises such little influence on the axillary and pubic hair. The 

 few cases of pronounced regression of this hair seem to me to belong under 

 the caption multiple ductless glandular sclerosis. 



The differential diagnosis has especially to consider the diseases of the 

 hypophysis that first develop in later years after the attainment of the com- 

 plete cessation of growth and complete maturity of the body. In this case 

 there is no disturbance of growth, as occurs in the differential diagnosis 

 between the eunuchoid and the hypophysial dystrophia adiposa-genitalis. 



