422 THE DISEASES OF THE SEXUAL GLANDS 



Where symptoms of brain-pressure are present and the X-ray shows altera- 

 tions of the sella turcica, the diagnosis is at once cleared up. Sometimes 

 difficult, however, is the delimitation from atrophic and inflammatory 

 sclerotic processes in the hypophysis. Perhaps points of differential diag- 

 nostic value can be obtained from the examination of the respiratory gaseous 

 exchange and of the purin metabolism. The history also ought to be im- 

 portant; the fact that the patient has sustained a luetic, gonorrhea], or 

 mumps orchitis should at any rate lead to the suspicion of late eunuchoidism. 

 The differential diagnosis with respect to multiple ductless glandular sclerosis 

 will be considered later. 



The treatment has not up to the present yielded anything reassuring. 

 That thyroid medication fails is indeed only too comprehensible. But also 

 the administration of sexual glandular substances has led to only transitory 

 results, or, as in the case of Dalche, led to improvement of symptoms that 

 probably were not to be referred to the lack of the sexual glands (forgetful- 

 ness, general weakness, chills). In the valuation of therapeutic results, we 

 should not forget that in certain cases spontaneous improvement is possible, 

 such as also occurs in early eunuchoidism. 



5. Treatment of Sexual Glandular Insufficiency 



The drug therapy of sexual glandular insufficiency has as yet had in man 

 no decisive results. The feeding with testicular substance is but little 

 carried out, and the reports as to the result of injection of sexual glandular 

 extracts disagree. Spermin (Poehl) may have a certain stimulating action 

 on the nervous system, but profound symptoms of insufficiency are hardly 

 improved thereby. 



In want of a better treatment, thyroid treatment has been recommended 

 a therapy that plays a part in the treatment of all ductless glandular affec- 

 tions, to a certain extent indeed, erroneously. In eunuchoid obesity, thyroid 

 medication has on the whole a good result and is certainly to be recom- 

 mended if it be employed with necessary caution. It is also conceivable 

 that through stimulation of metabolism often a certain furthering influence 

 is exerted on the sexual glands, but we cannot expect decisive results as to 

 this point. In such cases treatment with hypophysis tablets seems to be en- 

 tirely valueless. I do not know whether anybody has as yet employed 

 pituitrinum infundibulare. As I have mentioned already, perhaps employ- 

 ment of radium emanations would be of some value, but as yet no experiments 

 with them have been reported. I shall not go further into the question of the 

 other roborant and tonic treatment methods. 



The organotherapy of the symptoms due to loss rest on a much broader 

 experience as far as is concerned with woman. The medication with ovarian 

 substances was introduced by Regis and has been especially recommended by 



