628 ; EMIL NOVAK 



explained as due to ovarian secretory disorders. It is far more frequently 

 and more characteristically observed in association with disease of the 

 suprarenal bodies and occasionally of the pineal body. It it perhaps 

 best to consider it as a manifestation of pluriglandular disturbance. 



Female Eunuchoidism. Rarity of the Condition. As compared with 

 the corresponding condition in males, female eunuchoidism is exceedingly 

 rare. Indeed, only a few authentic cases are to be found in the literature. 

 The following abstract is given by Falta of the case reported by Josefson 

 and Sundquist: 



" Thirty-four-year-old woman, who had kept on growing from the 

 fifteenth year on (the growth had been especially active up to the twenty- 

 fourth year); she was 183.6 cm. tall (upper length 118 cm.), she had 

 never menstruated and had felt only slight inclination for men; the 

 mammae were small, flat, without palpable glandular substances, the 

 nipples very small ; she had rather a mannish appearance, but a feminine 

 voice. The form of the pelvis was rather womanly. The epiphyseal 

 junctures were closed, the sella turcica not enlarged. Examination of 

 the genitalia showed very small labia minora, a hypertrophic clitoris, the 

 vestibule was rather narrow, the internal genitalia were not palpable. No 

 introitus vaginae or hymen." 



Another case which Falta looks upon as an instance of probably genu- 

 ine eunuchoidism is that reported by Neurath. The patient was described 

 as an eleven-year-old tall-grown girl of typical "eunuchoid" obesity. 



Characteristics. As in the case of male eunuchoids, the three most 

 striking features of eunuchoidism, as manifested in women, are (1) the 

 characteristic skeletal proportions; (2) the typical fat distribution; (3) 

 a greater or less degree of genital hypoplasia. 



The Skeletal Characteristics. Practically all eunuchoids are tall. 

 At any rate, they are never below the average height, This is of some 

 importance as a point of differentiation from such conditions as adiposo- 

 genital dystrophy. There is a pronounced retardation of epiphyseal 

 closure. Especially striking is the disproportionate length of the extremi- 

 ties as compared with the trunk. This feature is always more marked 

 in the lower extremities. 



The Distribution of Fat. The characteristic eunuchoid distribution 

 of fat is marked by heavy deposits of adipose tissue especially in the 

 region of the lower abdomen, the mons veneris, the buttocks, and the outer 

 sides of the thighs. Frequently there is a deep furrow between the accumu- 

 lations in and above the mons. In many cases there is a marked adiposity 

 of the mammary glands. 



Genital Hypoplasia. While eunuchoidism is the result of a hypo- 

 ovarism, it is not usually possible to demonstrate clinically an actual 

 hypoplasia of the ovaries themselves. The uterus and vagina, however, 

 are always hypoplastic, and may be absent altogether, as in the case 



