426 THE DISEASES OF THE SEXUAL GLANDS 



who had developed normally until his fifth year; in that year an excessive 

 growth and especially a premature development of the genitalia and of the 

 secondary sexual characters set in; at the same time there developed a tumor 

 of the left testicle; at nine years of age the boy weighed 44 kg. and was 143 

 cm. tall. The lower length was 77 cm. Hence the boy showed childish di- 

 mensions, and was in this respect different from other true gigantism which, 

 as we shall see later, shows either normal or eunuchoid dimensions. The 

 testicular tumor, which was an alveolar carcinoma, was removed. One 

 month after the operation the beard hairs fell out and the abnormal hairiness 

 of the extremities retrogressed; the hairs on the mons Veneris remained. The 

 penis became smaller, the previously low 'voice became childish, and the 

 pollutions and erections ceased. 



In the female sex such cases are mostly described under the title men- 

 struatio prascox. The older literature is found in Kussmaul and v. Holler. 

 Neurath counts eighty-three cases from the literature. The external genitalia 

 develop in an abnormal manner, mostly more strongly than the internal. 

 The secondary sexual characters (hairiness, etc.) and the development of the 

 mammae are always abnormally premature. As in the male sex, excessive 

 growth of the body is found to be more or less pronounced. Also the den- 

 tition, the change of teeth, and the appearance of the bone nuclei and the 

 closure of the epiphysial junctures is premature. 



I cite the following: The case of Geinitz was one of menstruatio praecox in an eighteen- 

 month-old girl. The uterus had attained the size of a twelve- to fourteen-year-old 

 girl. The case of Klein, of menstruatio praecox (two and one-half years), the vulva had 

 grown to the size of that of a fourteen-year-old girl. Stacker describes twin sisters, of 

 whom one had been larger since birth. In the first, menstruation began before the end 

 of the first year. The flow occurred regularly every four weeks, lasting three days. At 

 eight years of age the child had the size and appearance of a twelve-year-old girl; she 

 measured 139 cm. and weighed 34% kg., while the twin sister was 121 cm. tall and 

 weighed 20 kg. The case of Neurath was that of a six-year-old girl who exceeded in size 

 and weight her eight-year-old sister. The ossification conditions corresponded to those 

 of the tenth or eleventh year. Recently there has been reported a case of Wolf concerning 

 a girl four years and one month old. The size had been large since birth. The child 

 had menstruated since the second year. She looks like a seven-year-old girl. The hair 

 of the head is long. The height is 121 cm., the weight 26 kg., the span width 114.5 cm - 

 (hence potentized childish dimensions). The intelligence corresponds to the age. The 

 mammae are very well developed. The mons Veneris is covered with hair. The ossi- 

 fication corresponds to that of a ten-year-old child. Especially instructive is the case of 

 v. Haller. In this the menstruation set in at the age of two years; at the age of eight 

 the girl became pregnant and shortly afterward the excessive growth stopped. She 

 lived to be seventy-five years old. This case shows that premature closure of the epiph- 

 yses may also occur in the female sex. Finally the case of Riedel shows that in certain 

 cases a primary hypergenitalism may be demonstrated also in females. In this case of 

 precocious menstruation (six-year-old child) the uterus was the size >f a seventeen-year- 

 old girl. There was a sarcoma of the ovaries ; on the removal of the sarcoma, the menstrua- 

 tion ceased. 



