io8 ENDOCRINE THERAPEUTICS 



the foregoing two types. In the first (Lorain- 

 Levi type) the genitals are infantile and function- 

 less, with the presence of sterility and impotence ; 

 whereas in the acromegalic the genitals are un- 

 usually well developed and associated with hyper- 

 sexuality. In pre-adolescent varieties of both 

 over- and under-activity of this lobe, there is a 

 tendency to decreased genital function. This is 

 present as a cardinal sign in the hypopituitary 

 post-adolescent subject, and is soon acquired in 

 the pre-adolescent hyperpituitarism, on account 

 of the early transition to inactivity in this 

 variety. 



Decreased genital function and muscle tonus 

 occurred so constantly with hypoactivity of the 

 anterior lobe, that they established themselves 

 as the best indicators of the state of activity of 

 this lobe. Hence, the genital functions (menses, 

 libido, and potency) and the muscular tonus 

 (muscle fatigue, or physical capacity), taken with 

 the temperature, pulse, and blood-pressure, were 

 considered, at the time of their determination, the 

 significant signs of activity. The osseous changes, 

 genital development, and secondary sex charac- 

 ters were interpreted as evidence of former 

 activity, which might have changed to the 

 opposite state." 



