20 ENDOCRINE GLANDS 



It had, however, been previously shown that castration 

 in man and in animals caused certain changes in the devel- 

 opment of the skeleton, thus showing the influence of the 

 genital glands. More recently this action was strikingly 

 demonstrated by the influence of the pituitary in certain 

 cases of infantilism, without there being any evidence of 

 any thyroid disturbance. In studying thyroid or pituitary 

 infantilism it was discovered that this was probably due 

 to alterations of the sexual glands. It would seem, there- 

 fore, that it was an alteration of the pituitary or of the 

 thyroid, which caused a disturbance of function of other 

 glands (the genital glands), resulting in infantilism; the 

 expression, not of the disturbance of one gland only, but 

 of a multitude of glands. We can sometimes wonder if 

 there is not a pre-existence of an endocrine disturbance on 

 another gland, if the initial alteration of this gland does not 

 represent the whole evolution. It seems to be the case in 

 the facts described by Gandy under the name of reversive 

 infantilism and byBrissaud and Bauer under the name of 

 late infantilism of adults \ sometimes of thyroid, sometimes 

 of pituitary origin. These cases are relatively numerous 

 and the course of the lesions can be clearly followed; in 

 those w r hich I have observed, I have seen quite clearly 

 the appearance of the pituitary lesion, with characteristic 

 symptoms, notably ocular disturbances, and secondarily 

 genital alterations followed by obesity and other changes. 



These facts, when the symptomatology is reconstructed, 

 show the simultaneous existence of lesions of several 

 endocrine glands. It is thus in a good many cases of sini- 

 lism, of gerodermia, genito-dystrophy, etc. It is partic- 

 ularly so in the very interesting cases analyzed by Claude, 

 Gougerous and Sourdel under the name of pluriglandular 

 syndromes. There is no question but that there are cases 

 which clinically and anatomically show alterations of sev- 



