HISTORY OF ENDOCRINE DOCTRINE 69 



Overf unction of the interrenal system (cortex of the suprarenal gland) pro- 

 duces changes in the sexual gonads, with such conditions as pseudoher- 

 maphroditism, precocious puberty, suprarenal virilism, and hirsutism. 



In disturbances of the endocrine functions of the sexual gonads, hyper- 

 genitalism and hypogenitalism may be independent of or associated with 

 disease of the pituitary, adrenals, or pineal glands, or with the "plurigland- 

 ular syndromes" in which more than one are involved. The concept 

 "pluriglandular insufficiency" was introduced by Claude and Gougerot 

 (1907-08). Sexual infantilism without obesity presents two types, the 

 typus Lorain (1871), with small consumptive looking body and delicate 

 limbs, and the myxinfantile or myxedematous type (typus Brissaud (a) 

 (&), 1897). The pluriglandular syndromes are usually characterized by 

 loss of sexual characteristics, impotence, neurasthenia, and by those remark- 

 able changes in the conformation and expression of the f acies which are fa- 

 miliar in acromegaly, goiter, and myxedema. Thus, in a pluriglandular 

 syndrome, well described by Walter Timme in 1918, the clinical picture, 

 characterized by muscular fatigability, sexual infantilism or abnormity, 

 low blood pressure and blood sugar, and Sergent/s white line of adrenal 

 insufficiency, is at first dominated by the enlarged thymus and latterly by 

 pituitary hyperplasia, with marked acromegalic symptoms. 



Perhaps the most interesting feature of the ductless glands is just this 

 correlation with the sexual function. Aside from the other correlations, 

 diminished sexual power is common to the two main groups of pituitary 

 disorders, acromegaly and sexual obesity with infantilism, although, in 

 acromegaly, sexual frigidity is not necessarily common to the initial or 

 transition stage, but usually comes on after the hyperpituitary stage has 

 been succeeded by dyspituitarism or hypopituitarism (L. F. Barker). 

 The well defined acromegalic has been likened to the Neanderthal man, 

 who was probably, as the gorillas are, hyperpituitary (Keith), to eunuchs, 

 who are excessively tall when not overeorpulent, and to the tall, raw boned, 

 heavy jawed peoples of the northern countries, who are often sexually 

 cold. The obese infantile patients of the Frohlich type, on the other hand, 

 suggest the fat boys of the Pickwick Papers and the large hotels, and the 

 eunuchoid "Lobengulas" described by Sir Jonathan Hutchinson. Even 

 in folklore, obesity connotes sexual frigidity. In a recent view of Dr. 

 Leonard Guthrie, the autopsy of the great Napoleon at St. Helena indi- 

 cates that the corpulence of his later years, his gradual loss of intellectual 

 keenness, his general fat-headedness from the time of the Russian cam- 

 paign, may have been due to the onset of a pituitary obesity, the dystrophia 

 adiposogenitalis of Mohr and Frohlich. In Frank Harris' recent life 

 of Oscar Wilde (New York, 1920), Bernard Shaw suggests that Wilde's 

 homosexualism may have been associated with latent acromegaly, as in- 

 dicated by his large flabby physique and heavy features. The logical oppo- 

 sites of acromegalics are, therefore, not the fat patients of the Mohr-Froh- 



