30 ENDOCRINE GLANDS 



to the study of the endocrines and the possibility of ac- 

 quired or congenital lues should be investigated. 



Disturbances of the genital organs, male or female, be 

 they primary or secondary to a known endocrine lesion, 

 should always lead to investigation of the possibility of 

 the disturbance of some other endocrine gland. 



Precocious amenorrhea has often revealed an alteration of 

 the thyroid or the pituitary. Impotence in the male, while 

 it is often the result of some acquired testicular lesion is 

 sometimes the sign of late infantilism of pituitary or 

 thyroid origin. In the same way, the absence of develop- 

 ment of the genitals in a young man is sometimes due to 

 the thyroid or pituitary causes of infantilism. Inversely, 

 hypersecretion of the ovary or hyperorchitis suggest 

 adrenal or pituitary lesions and Harvier has brought to- 

 gether the well-known facts of suprarenal virilism, hir- 

 sutism or pituitary obesity with precocious development 

 of the genital system. 



The various manifestations at the level of the skin or 

 its derivatives is very important. Squamous skin, 

 ichtyosis, wrinkled or senile skin, are symptoms of thy- 

 roid insufficiency. Dryness of the skin, decreased or 

 absent secretions have also been reported when there 

 was a thyroid insufficiency. Attacks of sweating have 

 inversely been noted in cases of hyperthyroidism. Pru- 

 ritus, urticaria, circumscribed edema, certain eczemas are 

 also manifestations of endocrine disturbances. Disturb- 

 ances in the cutaneous pigmentation, and specially 

 melanodermia are of great value as indicating some 

 change in the adrenals. The loss of hairs, particularly 

 the partial loss of the eyebrows has been given as an evi- 

 dence of abortive myxedema (Leopold-Levi and Roth- 

 child). This is also observed in certain affections of the 

 pituitary. Inversely, we see an exaggeration of the de- 



