460 PLURIGLANDULAR DISEASES 



the fact that only latterly did the obesity that occurred assume the eu- 

 nuchoid type (as far as I can see from pictures). This is true also of the 

 absence of beard, and the eunuchoid hairiness. "He has practically no 

 beard, and except for a scant pubic growth of feminine distribution, the 

 skin of the trunk and extremities is practically hairless." The hair of the 

 head was abundant. 



Also in the case described by Levi and Franchini did there occur a late 

 eunuchoid obesity. 



The abnormal growth began in this person, who was sixty-five years old, at the age of 

 eight to ten years, the secondary sexual characters were apparently normally developed at 

 the time of puberty, there were few erections, however, and there never had existed an 

 especial libido. The external genitalia were normal, as was also the mental development. 

 He was always weak muscularly, in the last few years obesity developed, the distal parts of 

 the extremities showed a considerable enlargement, there existed cervicodorsal kyphosis, 

 in short the signs of an acromegaly that had gradually developed over a long period of 

 time. The epiphysial junctures were closed. 



I now adduce several examples of the eunuchoid type, in which the 

 symptoms of deficiency on the part of the sexual glands already exerted an 

 influence on skeletal formation in early youth. Here belongs the giant 

 Charles described by Launois and Roy. In the thirtieth year of his life, 

 his height was 204 cm. The lower length was considerably more than the 

 upper length. The penis was small, the testicles were very small, and the 

 prostate also was small. He had had on several occasions erections, but 

 never ejaculations. The hairiness of the trunk was typically eunuchoid. 

 The epiphysial junctures were entirely open. In later life, acromegalic 

 features made their appearance. 



A pronounced case is reported by Gushing that on account of the mon- 

 strosity present I shall herewith adduce; thirty-six* year-old man; he was al- 

 ready as a boy abnormally tall, and from the fifteenth year on grew enormously. 

 For ten years he has been sick and weak. At autopsy the body measured 

 251.5 cm., the skin is delicate, hairness of the head good, no growth of beard, 

 no axillary hairiness, sparse hairiness of the pubic region. The genitalia are 

 small, the testicles atrophied. The distal epiphysial juncture of the radius 

 is still open, no alimentary glycosuria. Distinct symptoms of acromegaly are 

 present. The sella turcica is very much enlarged (2.2 to 2.7 cm.) and the 

 hypophysis consists, in great part, of a cyst. 



Again, in such eunuchoid giants the acromegalic alterations may be very 

 significant. There are also known female eunuchoid giants. As example I 

 adduced Lady Aama, described by Woods Hutchinson. She was about 

 seventeen to nineteen years old, 244 cm. tall, and trie lower length far ex- 

 ceeded the upper length ; hands and lower jaw were very large. The genitalia 

 were infantile, the mons Veneris was poorly developed, the labia majora were 

 flat, the clitoris was well developed and resembled a poorly developed penis. 



