248 ENDOCRINE GLANDS 



Menstrual disturbances are nearly always present; the 

 genital organs regress; the uterus becomes of the infantile 

 type. In other words, in both sexes there is a loss of the 

 secondary sexual characteristics and the evolution towards 

 a neutral type. 



This is the most frequent type, but there may 

 be variations : 



(a) The affection may begin with changes in the 

 pigmentation accompanied by vertigo and lassitude. This 

 pigmentation is more pronounced than in the preceding 

 type, and resembles that of Addison's disease. It differs, 

 however, in its location, for it usually affects the non 

 pigmented parts. 



(6) In other cases, particularly in women, the symptoms 

 of hypothyroidism predominate. Following the cessa- 

 tion of the menses appear signs of myxedema: adiposity, 

 thickening of the skin, yellowish and puffed faces. As in 

 the preceding cases there are disturbances of the growth 

 of the hairs; hypotension and asthenia. 



EVOLUTION. 



This condition evolutes very slowly and lasts for a long 

 time. There are periods of improvement in summer or 

 following organo therapy. They usually die of cachexia, 

 showing a progressive asthenia, comparable to Addison's 

 disease or following some intercurrent infection, very 

 often tuberculosis. 



DIAGNOSIS. 



The interpretation of this thyroid-testicular-adrenal 

 syndrome has been very much disputed. According to 

 which one of the three glands was most affected, writers 

 have described it under different names. 



It has, for instance, been called: abortive myxedema. 



