THE SYMPATHETIC SYSTEM 247 



finally disappears. At the same time the skin takes on a 

 yellowish color and becomes slightly infiltrated. 



Once the syndrome established the patients take on a 

 characteristic appearance. They appear like old men. 

 The beard has fallen out and only a few hairs, or none at 

 all, are left. The hairs do not fall out, but become dry, 

 break easily and turn white prematurely. The eyelashes 

 and eyebrows sometimes fall out. The skin is wrinkled and 

 at the same time thickened and dry, often pigmeiited; it 

 appears dirty when the pigmentation is slight and diffuse. 



The body shows a certain degree of adiposity; the skin 

 is fine, white and slightly greasy to the touch. The 

 regions normally pigmented are frequently discolored. It 

 is not rare to find on the body spots of pruritus, surrounded 

 by an area of pigmentation. Often the morphology 

 approaches the feminine: hypertrophy of the breasts, 

 widening of the hips, infiltration of the pubis with fat. 

 The hairs are missing or rarified in the axilla, on pubis and 

 on the limbs. 



The genital organs are atrophied; the penis is decreased 

 in size; the testicle the size of a pigeon's egg and soft. 

 Sexual desire nearly always disappears. 



From a functional point of view the patients complain 

 of a marked asthenia: muscular strength is very much 

 decreased. They are apathetic or indifferent. Their 

 character is irascible. Some cry without any particular 

 reason; some realize their degeneration and become 

 neurasthenic. They are extremely susceptible to the 

 cold and even in the summer time still feel frozen. With 

 this is associated a decrease in the blood pressure. 



In women the symptoms are comparable. The fem- 

 inine shape is lost. The breasts become atrophic; the 

 pelvis becomes narrower. The hairs in the pubis and 

 axilla fall out, while the chin is covered with a fine fuzz. 



